National Primary Medical Care Survey (NatMedCa)

This study was undertaken to describe consultations between primary health care providers and their patients. The research was led by Professor Peter Davis with a team from the Centre for Health Services Research and Policy, The University of Auckland, in collaboration with the University of Otago. The survey was funded by the Health Research Council of New Zealand, with practical support from the academic Departments of General Practice and from the Royal New Zealand College of General Practitioners.

The reports resulting from the study provide in-depth information on the content of consultations between practitioners and patients. The survey collected information from private General Practitioners; GPs and nurses in community governed non-profits and in Maori-led practices; doctors and nurses in accident and medical clinics (A&Ms); and a sample of primary care activity that takes place in Emergency Departments (EDs).

From this data set a wide range of analyses were possible. Each of the reports has material on relevant literature, the methodology of the study, patients’ normal relationship to the practice, characteristics of the consultation (such as the time of day, source of payment and urgency), the problems patients brought to the consultation, tests and investigations, referrals and admissions, drugs prescribed and other treatments determined by the health care provider.

A representative sample of providers was drawn for the study and included general practitioners in private practice, in community governed non-profits (GPs and nurses) and a smaller sample of Maori providers (GPs and nurses). The representative sample of practitioners was drawn from across the country. In the selected general practices data were collected for two complete weeks six months apart. Basic data were kept on every visit during those weeks, and detailed information was recorded on every fourth patient. Over 42,000 interactions were recorded with full data kept for 9,682 consultations. In the sample of 12 Accident and Medical Clinics data were only kept for one week. Over 6,000 consultations were recorded with full data on 1,430 consultations.

The complex sampling process allowed comparison between visits in different types of provider organisations, for example private GPs and GPs in community governed non-profits. It also allowed for comparisons of consultations with different population groups, for example by age or ethnicity. The Ministry of Health commissioned nine reports based on these data. Five of these described the experiences of doctors in different types of provider originations, including those in A&Ms. One report addressed the experiences of primary health care nurses and another described activities in Emergency Departments. Two reports focused on the experiences of Maori and of Pacific patients in different provider organisations.

Four reports were released by the Ministry of Health in August 2004:

1. Family Doctors: Methodology and description of the activity of private GPs
2. Primary Health Care in Community-governed Non-Profits: The work of doctors and nurses
3. Maori Providers: Primary health care delivered by doctors and nurses
4. A Comparison of Primary Health Care Provided by Rural and Non-Rural General Practices

Five further reports were released in April 2006:

1. The work of doctors in accident and medical clinics
2. A comparison of Maori and non-Maori patient visits to doctors
3. Pacific patterns in primary health care: a comparison of Pacific and all patient visits to doctors
4. A description of activity of selected hospital emergency departments in New Zealand
5. Nurses and their work in primary health care
    

You can download the reports from the Ministry of Health’s website .

Two articles were published in the Health Care and Informatics Review Online in 2007:

1. Comparative Study Of Electronic Pilot And Paper Data Collection Methods In A Survey Of General Practice Consultations
2. “Data Salvage” in Hospital Emergency Departments: Extracting Usable Information From Electronic Data Systems