Utilization of general practitioner services in New Zealand and its relationship with income, ethnicity and government subsidy.

The New Zealand primary care system involves user part-charges for general practitioner (GP) care. This study explores the relationship between the use of GP services in New Zealand and government subsidies, income and ethnicity. The study used the 1996/97 New Zealand Health Survey dataset, a nationally representative household survey of health status and health service utilization. Multivariate logistic regression models were used to estimate the likelihood of visiting the GP at least once in 12 months, and the likelihood of frequent visits (at least six visits in 12 months). Adjustment was made for health need (as indicated by global self-reported health status and a number of specific disease and health-related behaviour measures), together with a range of other relevant demographic and socio-economic variables. Following these adjustments, low-income groups and Mäori were found to be significantly less likely to visit the GP at least once in the year, but there were no significant differences across income or ethnic groups in the likelihood of frequent visits. These results suggest that the system of low-income targeted government subsidies reduces, but does not fully compensate for the barrier posed by doctors' fees. Moreover, there appear to be barriers for indigenous groups, in addition to income.