Journal of primary health care最新文献_第2页

Protecting primary healthcare funding in Aotearoa New Zealand: a cross-sectional analysis of funding data 2009-2023. 保护新西兰奥特罗阿的初级保健资金：2009-2023年供资数据的横断面分析。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC24155

Maite Irurzun-Lopez, Mona Jeffreys, Jacqueline Cumming

{"title":"Protecting primary healthcare funding in Aotearoa New Zealand: a cross-sectional analysis of funding data 2009-2023.","authors":"Maite Irurzun-Lopez, Mona Jeffreys, Jacqueline Cumming","doi":"10.1071/HC24155","DOIUrl":"10.1071/HC24155","url":null,"abstract":"Introduction In 2001, Aotearoa New Zealand (NZ) launched a Primary Health Care (PHC) Strategy to improve access, reduce inequities, and shift care toward the community level. Those goals have remained in place since. Despite initial successes, multiple challenges indicate PHC remains underfunded. Aim This study aims to assess the extent to which PHC has been financially prioritised within public spending between 2009 and 2023. Methods We use Ministry of Health transfers to Primary Health Organisations (PHOs) as a proxy for PHC funding, including general practice capitation and PHC capacity investments. We analyse PHC funding trends relative to total government health funding, adjusted for inflation, in total and per capita terms, and examine changes in key funding streams. Results On average, NZ spent NZ$238 per person per year on PHC in 2023 prices, reflecting a slight 7% increase since 2009. Although PHO funding has diversified over time, it remains dominated by First Contact Funding, which accounted for 70% of total PHC funding. On average, NZ allocated 5.4% of its national health budget to PHC, a share that did not change throughout the study period. Discussion The findings highlight the need for greater financial prioritisation of PHC in NZ to fulfil the PHC Strategy. Despite nominal increases, the static share of PHC funding suggests that successive governments have not sufficiently prioritised PHC funding to align with their strategic PHC goals. We recommend routine monitoring of PHC funding relative to the total government health budget and setting a minimum allocation to help protect spending on PHC.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"108-114"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An update on Closed Books in general practice in Aotearoa New Zealand. 关于新西兰奥特罗阿全科实践中的闭卷书的最新情况。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC24164

Megan Pledger, Maite Irurzun-Lopez, Jacqueline Cumming

{"title":"An update on Closed Books in general practice in Aotearoa New Zealand.","authors":"Megan Pledger, Maite Irurzun-Lopez, Jacqueline Cumming","doi":"10.1071/HC24164","DOIUrl":"10.1071/HC24164","url":null,"abstract":"Introduction People are precluded from enrolling in primary health care at a general practice if it has 'Closed Books'. This creates barriers to accessing health care. Aim To examine which Health Districts had the greatest number and proportion of general practices with Closed Books and how this has changed since 2022. Methods Maps were used to display the distribution of Closed Books general practices and tables were used to compare changes in Health Districts over time. Results There were 373 (36%) general practices that had Closed Books in September 2024. Canterbury (n = 56), Southern (37) and Northland (32) Health Districts had the greatest number of Closed Books general practices, while Hutt Valley (73%), Lakes (70%) and Wairarapa (67%) Health Districts had the greatest percentage of general practices with Closed Books. Discussion The problem of Closed Books was felt across the country but has a larger impact in the middle-lower North Island and an increase in impact in Northland and the lower South Island. Improvements have been seen in the worst hit areas since 2022 but, overall, the percentage of general practices with Closed Books has not improved.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"194-199"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

'We're not taking on any new patients': the reality of the funding and workforce crisis in primary care. “我们不接受任何新病人”：初级保健的资金和劳动力危机的现实。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC25095

Felicity Goodyear-Smith, Tim Stokes

引用次数: 0

Use of silver diamine fluoride in New Zealand public dental services: a scoping review on caries prevention and management in children. 新西兰公共牙科服务中氟化二胺银的使用：儿童龋齿预防和管理范围审查。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC24134

Xinyu Rachel Zhang, Heuiwon Han, Julie Trafford

{"title":"Use of silver diamine fluoride in New Zealand public dental services: a scoping review on caries prevention and management in children.","authors":"Xinyu Rachel Zhang, Heuiwon Han, Julie Trafford","doi":"10.1071/HC24134","DOIUrl":"10.1071/HC24134","url":null,"abstract":"Introduction Despite government-funded dental care for children in New Zealand, dental caries was the leading cause of children's hospitalisations in 2019, with 10.4% of children aged Aim The review aims to map international literature on the use of silver diamine fluoride in preventing and managing dental caries, and to assess its contribution to achieving better and more equitable oral health outcomes for children aged 0-14years. Methods The scoping review adhered to the scoping review guideline from the Joanna Briggs Institute Manual for Evidence Synthesis. Six databases were searched for primary studies addressing the uses of silver diamine fluoride as a caries management tool in paediatric dentistry. Results Of 1185 records screened, 88 studieswere included. The results were categorised into five themes: (1) effectiveness; (2) enablers; (3) adverse effects and barriers; (4) cost-effectiveness; and (5) promotion of oral health equity. The capability of silver diamine fluoride to arrest dental caries is well-supported by evidence, offering benefits such as non-invasiveness and improved quality of life for children. However, aesthetic concerns post-treatment and limited public awareness pose challenges to its broader application. Discussion Silver diamine fluoride has the potential to significantly reduce caries rates among New Zealand children. Further research is needed to explore its role in promoting oral health equity, and tailored policies and protocols need to be developed to align with the local context.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"183-193"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How is the user base of general practices associated with Open or Closed Books in Aotearoa New Zealand? An analysis of administrative data. 在新西兰的奥特罗阿，与开放或关闭书籍相关的一般实践的用户基础如何？管理数据的分析。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC24177

Megan Pledger, Maite Irurzun-Lopez, Jacqueline Cumming

{"title":"How is the user base of general practices associated with Open or Closed Books in Aotearoa New Zealand? An analysis of administrative data.","authors":"Megan Pledger, Maite Irurzun-Lopez, Jacqueline Cumming","doi":"10.1071/HC24177","DOIUrl":"10.1071/HC24177","url":null,"abstract":"Introduction In Aotearoa New Zealand (NZ), general practices are able to close their books, meaning that they do not enrol any new patients at all. This can increase the barriers that people face in accessing health care and may affect different groups disproportionately. Aim This study aimed to examine the link between the enrolling status of general practices and the characteristics of the population in areas served by these practices, ie the user base, across New Zealand. Methods Regression models, with bootstrapping, were used to explore the relationship between Open and Closed Books general practices and the variables: sex, median age, total count ethnicity, being born in New Zealand, median personal income, the New Zealand Deprivation Index 2023, health status, and the Urban Accessibility Index in the area surrounding the general practices. Results Being a Closed Books general practice was more likely when the user base had higher proportions of people born in New Zealand, had lower health status, were Māori or European, were female, and lived in a large or medium urban area. It was less likely when there were higher proportions of males and Asian peoples. After adjusting for Health Districts, only one variable, being born in New Zealand, remained significant. Discussion Characteristics of the user base were associated with a general practices' enrolling status and mediated by location. These findings contribute to a deeper understanding of the inequalities affecting access to primary health care and point to the potential of geographically tailored approaches to minimise disparities and promote healthcare equity.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"115-122"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Te hāpai i te mana wāhine, te takahi i te mana wāhine: Māori women's experiences of empowerment and disempowerment in sexual and reproductive healthcare. hāpai在mana wāhine， takahi在mana wāhine: Māori妇女在性保健和生殖保健方面的赋权和剥夺赋权经验。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC25037

Chelsea Harris, Susan Bidwell, Ben Hudson, Maira Patu, Christina McKerchar, Ibrahim S Al-Busaidi

{"title":"Te hāpai i te mana wāhine, te takahi i te mana wāhine: Māori women's experiences of empowerment and disempowerment in sexual and reproductive healthcare.","authors":"Chelsea Harris, Susan Bidwell, Ben Hudson, Maira Patu, Christina McKerchar, Ibrahim S Al-Busaidi","doi":"10.1071/HC25037","DOIUrl":"10.1071/HC25037","url":null,"abstract":"Introduction Māori have poorer sexual and reproductive health (SRH) outcomes compared to non-Māori New Zealanders. Patient experiences of SRH services affect how they access, utilise, and benefit from services. Learning about how wāhine Māori (Māori women) experience care related to SRH could inform improvements in how services provide care for wāhine. Aim This study aimed to explore the experiences wāhine have when accessing SRH services. Methods This qualitative study utilised semi-structured interviews to explore the lived experiences of wāhine when accessing sexual healthcare. Inductive thematic analysis was performed to generate themes from the data. Results Twelve wāhine were interviewed. An overarching theme, Te Hāpai i te mana wāhine, te takahi i te mana wāhine (empowering women, disempowering women), was identified. This theme had four subthemes: creating comfortable spaces; manaakitanga (kindness and respect) overcomes barriers to care; patients are people, not numbers; and the importance of mana-enhancing care. The data showed that wāhine benefit from services and care that make them feel comfortable and respected and that dehumanising care can impact further engagement with services. Discussion Wāhine have variable experiences when accessing sexual healthcare, and although some of those experiences showed how positive interactions with healthcare staff facilitated effective care, many experiences demonstrated how dehumanising clinical care can sometimes be. Such care risks perpetuating health inequities indirectly by eroding the trust wāhine have in healthcare services, and directly by limiting the effectiveness of healthcare encounters. Recommendations are made to improve care provided to wāhine in sexual health settings.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"154-160"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Towards new forms of communication and surveillance: a mixed methods study of rapid respiratory virus assessment in general practice during the SARS-CoV-2 pandemic. 迈向通信和监测新形式：SARS-CoV-2大流行期间全科实践中呼吸道病毒快速评估的混合方法研究

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC24051

Anthony Dowell, Sue Huang, Christine McIntosh, Michelle Balm, Isabella Cheung, Lorraine Castelino, Nikki Turner

{"title":"Towards new forms of communication and surveillance: a mixed methods study of rapid respiratory virus assessment in general practice during the SARS-CoV-2 pandemic.","authors":"Anthony Dowell, Sue Huang, Christine McIntosh, Michelle Balm, Isabella Cheung, Lorraine Castelino, Nikki Turner","doi":"10.1071/HC24051","DOIUrl":"10.1071/HC24051","url":null,"abstract":"Introduction Improvements in diagnostic test accuracy across multiple pathogens have resulted in multi-viral point-of-care testing (POCT) via a rapid antigen test (RAT). Aim This study aimed to describe general practice practitioners' reactions to a pilot respiratory virus surveillance programme during the SARS-CoV-2 pandemic, which enabled surveillance for influenza and other respiratory viruses alongside POCT for SARS-CoV-2. Methods Participating general practices collected viral swabs between May and December 2022. Nasopharyngeal swabs were taken for both an immediate COVID-19 RAT and a polymerase chain reaction (PCR) for testing SARS-CoV-2, influenza, respiratory syncytial virus (RSV) and other respiratory viruses. A questionnaire explored practitioners' experiences and perceptions, addressing project setup, swabbing process and perceived overall value. Results Of 4135 swabbed patients, 54% were positive for one of the tested viruses. Involved nurses and doctors reported high adaptability to the swabbing process. Clinicians valued obtaining rapid diagnostic information for patient management and patient communication. While no significant barriers were identified, practitioners acknowledged additional time requirements and potential challenges with swabbing young children. Discussion The study demonstrated the feasibility and clinical utility of using POCT swabbing for immediate RAT and subsequent PCR testing for respiratory viruses in general practices when managing a viral pandemic. The data assisted in identifying community transmission of respiratory viruses, provided information for patient management and reinforced positive health messages about viral illnesses. The study suggests potential benefits for both individual patient care and population-based surveillance. The study also identified the potential value of multi-viral POCT testing via a RAT.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"161-166"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing dental caries experiences and dental service delivery for children with disabilities in Auckland, New Zealand: a mixed-method study. 评估新西兰奥克兰残疾儿童龋齿经历和牙科服务：一项混合方法研究。

IF 0.9

Journal of primary health care Pub Date : 2025-06-01 DOI: 10.1071/HC25054

Anishma Mohini Ram, Heuiwon Han

{"title":"Assessing dental caries experiences and dental service delivery for children with disabilities in Auckland, New Zealand: a mixed-method study.","authors":"Anishma Mohini Ram, Heuiwon Han","doi":"10.1071/HC25054","DOIUrl":"10.1071/HC25054","url":null,"abstract":"Introduction Despite free dental care for children under 18 in New Zealand, children with disabilities face significant barriers to accessing these services, leading to disproportionately poorer oral health outcomes. A detailed understanding of the oral health status and service delivery for children with disabilities is essential to identify existing gaps and areas for improvement. Aim The study aims to examine the oral health status of children with disabilities in Auckland, New Zealand and explore the perspectives of clinicians and service managers working in the community dental service regarding oral health care for these children. Methods An explanatory sequential mixed-method design was utilised. The initial quantitative phase involved retrospective analysis of dental records of children with disabilities who received care through the community dental service. This was followed by the qualitative phase, which consisted of semi-structured interviews with clinicians and service managers. Results The study identified high caries rates and significant unmet dental care needs among children with disabilities. Clinicians and service managers recognised individual-level challenges, such as insufficient confidence and training. Additionally, broader systemic issues, including inadequate service design and barriers in service delivery, were also highlighted, contributing significantly to oral health disparities. Discussion This study highlights the urgent need for tailored dental services for children with disabilities in Auckland. It emphasises the importance of integrated care approaches and enhanced training for dental professionals to improve accessibility and outcomes in paediatric dental health care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 2","pages":"176-182"},"PeriodicalIF":0.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do antidepressants help people with low back pain? 抗抑郁药对腰痛有帮助吗？

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC25046

Vanessa Jordan

引用次数: 0

Nurses' and general practitioners' perspectives on oral health in primary care: a qualitative study. 护士和全科医生对初级保健口腔健康的看法：一项定性研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC23153

Moira B Smith, Elizabeth Hitchings, Lynn McBain

{"title":"Nurses' and general practitioners' perspectives on oral health in primary care: a qualitative study.","authors":"Moira B Smith, Elizabeth Hitchings, Lynn McBain","doi":"10.1071/HC23153","DOIUrl":"10.1071/HC23153","url":null,"abstract":"Introduction Integrating oral health into primary health care (PHC) is recommended, thereby ensuring comprehensive patient care. Primary care teams are well placed to promote and protect patients' oral health, and frequently see oral health-related complaints, and so need to be sufficiently knowledgeable to manage such presentations. There is limited local evidence to inform acceptable and feasible ways of integrating oral health into PHC in Aotearoa New Zealand. Aim To explore the views of doctors and nurses on the place of oral health, and how to improve its inclusion, in PHC. Methods Focus groups with nurses and doctors from six practices were conducted. Data were analysed thematically. Results Several factors influenced the inclusion of oral health in PHC and management of oral health presentations, at individual, professional and system levels: low oral health knowledge, skill and confidence in managing presentations, and lack of communication with local dental services (individual level); considering oral health as out-of-scope of practice, competing priorities, time constraints and ethical considerations (professional level); and lack of affordable and timely definitive oral health care and referral pathways (systems level). Suggestions to facilitate integration of oral health in PHC included information sessions on oral health, developing relationships with local dental professionals, and health system changes. Discussion Primary care practitioners are open to incorporating oral health into their practice; however, several barriers exist to do so sustainably. For effective integration, a series of individual-, professional- and system-level changes are likely required.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"10-16"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0