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Unmet need for referred services as measured by general practice
Graham McGeoch1, Kieran Holland1, Melissa Kerdemelidis2
1Canterbury Initiative, Canterbury District Health Board, Christchurch, New Zealand.
Journal of Primary Health Care
|March 14, 2018
Summary
A New Zealand survey found 3.6% of patients had unserviced health needs, particularly in orthopaedic, general surgery, and mental health. This highlights hidden gaps in healthcare access for those with greater deprivation and middle-aged individuals.
Area of Science:
- Health Services Research
- Public Health
- General Practice
Background:
- Unmet healthcare needs are critical indicators of health system performance.
- Clinicians and funders in Canterbury, New Zealand, suspected hidden unmet health needs.
- Existing measures like declined referral rates may not fully capture patient needs.
Purpose of the Study:
- To estimate the proportion of patients attending general practice unable to access clinically indicated referred services.
- To identify specific areas with significant unserviced health needs.
- To explore factors associated with unserviced health needs.
Main Methods:
- A novel survey involving 54 general practitioners (GPs) and 2135 patients in Canterbury, New Zealand.
- GPs and patients jointly identified health needs requiring referred services but unavailable.
- Data collected via an e-referral system, with outcomes of actual referrals also reviewed.
Main Results:
- 3.6% of patients had a GP-confirmed unserviced health need after demographic adjustment.
- Areas of greatest need included elective orthopaedic surgery, general surgery, and mental health services.
- Unserviced needs were significantly associated with higher deprivation, middle age, and high health-use subsidies.
Conclusions:
- This study provides the first survey of GP and patient agreement on unserviced referred health needs.
- The novel method directly identifies clinically indicated services that patients need but cannot access.
- Findings are directly relevant for health service planning to address identified gaps in care.
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