The Waikato Medical Care (WaiMedCa) Survey 1991-1992

Objective. The main objective of this study is to provide a comprehensive description of general practice in the Waikato, an area which represents many aspects of New Zealand. Accurate, detailed and up to date information in this area is needed for future planning of medical education and the provision of health services. Survey method. The survey was conducted over one year, from September 1991 to August 1992. Participating general practitioners and practice nurses recorded details of a sample of patient encounters in the surgery or on home visits. Each participant was assigned four single weeks for data gathering over the course of the year. A one in five sub-sample of patients was also given questionnaires to complete immediately and two weeks after the consultations. This component of the study was reported elsewhere. Participants. A list of all active general practitioners working within the area covered by the Waikato Area Health board was constructed. All were contacted during May and June 1991 and asked to contribute to the study. During this initial, recruiting stage the practitioners and their practice nurses were asked to provide details of their professional background and to outline the structure, functions and size of their practices. Data collection. The variables studied included: provider characteristics (age, gender, qualifications, type of practice and services offered); patient attributes (age, gender, ethnicity, benefit category and occupation); patient reasons for encounter (up to four per encounter); doctor diagnoses (again up to four per encounter); drugs prescribed and or other treatments provided; tests and investigations ordered and referrals made; planned follow up and subjective view on the encounter. Data were centrally coded by trained staff. Patient reasons for encounter were coded according to NAMCS, practitioner diagnoses were classified into OXMIS, and drugs prescribed were allocated into the ATC classification system. Participation rate. 87% of practitioners (182/209), 89% of practices (95/107), and 80% of practice nurses (150/189) completed the initial recruitment survey. The participation rate at the first phase of the encounter survey was 80.5% (169/210), but this had dropped to 65.7% (136/207) by the fourth collection week. An overall response rate of 68.6% was achieved, representing successful collection of encounter data in 562 of 819 potential doctor recording weeks. On average, general practitioners recorded 109 encounters per week, from which they selected on average a sample of 23 patients for the survey. They described 141 problems per 100 encounters, of which 49 were new. On average general practitioners made less than three home visits per 100 encounters.(ABSTRACT TRUNCATED AT 400 WORDS)