Patients consulting outside of funded practices within primary health organisations: implications for utilisation...

To consider two definitions for utilisation reporting in primary care in New Zealand and to assess the affect of two reporting methods on volumes of utilisation in four primary health organisations (PHOs).

Utilisation data was analysed for a 6-month period from 60 practices across four PHOs. Analysis was based on comparing the expected volumes from two alternative collection and reporting methods, named "matched" and "unmatched" reporting. The "unmatched" method is potentially sensitive to patients consulting outside of the practice in which they are funded. Volumes were grouped into categories based on those used for reporting.

There was up to 25% difference in volumes in some reporting groups depending on the matching method used. Several of these were for high deprivation, New Zealand Maori, Pacific Islanders, and Community Service Card (CSC) holders--all potentially target populations within PHOs. Two PHOs were more affected having a total of 7.6% and 6.4% fewer reported encounters using the "unmatched" method. Data implies that some groups of patients may not be receiving continuity of care.

There were differences in reporting volumes between the two methods. The Ministry of Health (MOH), district health boards (DHBs), and PHOs should be aware of how these results may potentially apply to them, especially where they have after-hours services or target groups as minorities.