Ethnicity, socioeconomic deprivation and consultation rates in New Zealand general practice

Objectives: To explore the relationship between ethnicity, socioeconomic deprivation and utilization of general practice. Methods: Data routinely collected by New Zealand general practices in 2001 were analysed using generalized linear regression. Results: The mean number of doctor consultations for registered individuals was 3.7 and the median 2. After adjusting for age, gender and area socioeconomic deprivation, people from Maori, Pacific, Asian and other-unspecified ethnic groups consulted general practitioners at similar rates or less frequently than European people. There was a significant positive trend between increasing deprivation and increasing rates of general practitioner (GP) consultation. The most-deprived groups had an approximately 30% higher rate of consultation than the least-deprived groups. There was a significant negative trend between nurse consultations and deprivation, with people from the most-deprived groups having a 29% lower frequency of nurse consultation. There was a different pattern of doctor consultation in the under-six age group, where a higher rate of patient subsidy was available, suggesting cost may be a barrier to doctor consultation for other age groups. Conclusions: In the general practices, in this study, the increasing rate of doctor consultations with increasing socioeconomic deprivation is consistent with increased need. However, the fact that adjusted Maori and Pacific utilization rates were not higher than those for people of European ethnic identity is a cause for concern in light of evidence that Maori health status is poorer than European, even after adjusting for deprivation. Further research is required to explore potential barriers to general practice consultation.