Jennifer Reid1, Donna Cormack2, Marie Crowe1. 1. Christchurch School of Medicine, University of Otago, New Zealand. 2. Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, New Zealand.
Abstract
OBJECTIVE: This qualitative study explored self-reported experiences of primary healthcare among a sample of urban Māori adults. This paper specifically focuses on the theme of relational continuity of care identified in participant discussions of access and engagement with their predominantly non-Māori general practitioners (GPs). METHODS: The study involved a purposively selected subsample (n=42) of the Christchurch Māori cohort of the Hauora Manawa Community Heart Study (n=244). Participants took part in in-depth interviews, which were transcribed and analysed thematically. RESULTS: Analysis identified compromised access to a preferred GP as a principal barrier to receiving quality and non-discriminatory care from predominantly non-Māori clinicians. In contrast to discussions of healthcare provided by usual GPs, episodic encounters with non-regular clinicians were commonly framed as experiences discouraging utilisation and the perceived value of primary healthcare. CONCLUSIONS: Facilitating relational continuity of care for Māori patients and their clinicians may contribute towards mediating determinants of inequality at the clinical interface. IMPLICATIONS: Reducing significant health disparities between Māori and non-Māori was a key goal of the reconfiguration of primary healthcare in the early 2000s. The role of relational continuity of care in achieving equitable inter-ethnic health outcomes in primary healthcare settings is an important consideration.
OBJECTIVE: This qualitative study explored self-reported experiences of primary healthcare among a sample of urban Māori adults. This paper specifically focuses on the theme of relational continuity of care identified in participant discussions of access and engagement with their predominantly non-Māori general practitioners (GPs). METHODS: The study involved a purposively selected subsample (n=42) of the Christchurch Māori cohort of the Hauora Manawa Community Heart Study (n=244). Participants took part in in-depth interviews, which were transcribed and analysed thematically. RESULTS: Analysis identified compromised access to a preferred GP as a principal barrier to receiving quality and non-discriminatory care from predominantly non-Māori clinicians. In contrast to discussions of healthcare provided by usual GPs, episodic encounters with non-regular clinicians were commonly framed as experiences discouraging utilisation and the perceived value of primary healthcare. CONCLUSIONS: Facilitating relational continuity of care for Māori patients and their clinicians may contribute towards mediating determinants of inequality at the clinical interface. IMPLICATIONS: Reducing significant health disparities between Māori and non-Māori was a key goal of the reconfiguration of primary healthcare in the early 2000s. The role of relational continuity of care in achieving equitable inter-ethnic health outcomes in primary healthcare settings is an important consideration.
Authors: Serena MacDonald; Colleen Judge-Golden; Sonya Borrero; Xinhua Zhao; Maria K Mor; Leslie R M Hausmann Journal: Med Care Date: 2020-05 Impact factor: 2.983