ニュージーランドで満たされていない二次医療需要の定量化:行政データを用いた多年にわたる人口調査
Nicholas Bowden1,2, Jerram Bateman3, Robin Gauld4,5
1Department of Paediatrics and Child Health, University of Otago, Dunedin, New Zealand.
BMJ open
|September 2, 2025
まとめ
ニュージーランドでは,専門医への紹介の減少が毎年増加しており,満たされていない医療需要の増加を示しています. この傾向は,特に特定の社会人口集団や地域における健康格差を悪化させ,緊急の政策介入を必要とします.
科学分野:
- 医療サービス研究
- 医療の公平性に関する研究
- 公衆衛生政策
背景:
- 2次医療への紹介の減少は,潜在的に満たされていない医療ニーズ (UMN) の重要な指標です.
- 拒否された紹介のパターンを理解することは,医療へのアクセス格差を特定し,対処するために不可欠です.
- 以前の研究によると UMNは特定の社会人口統計的グループや地域に影響を及ぼす可能性がある.
研究 の 目的:
- ニュージーランドで最初の専門家の評価 (FSA) に関する紹介の減少傾向を調べる.
- 社会統計学,地域,医療専門分野による 拒絶された紹介の変動を分析する.
- UMNのマーカーとして拒否された紹介の時間的変化を評価する.
主な方法:
- 国家患者フロー (NPF) コレクション (2018年-2022年) の行政データの横断分析を繰り返す.
- ニュージーランドの公立病院の専門医へのすべてのFSA紹介を含む全国的なデータ.
- 主要な結果の分析:FSAの紹介は優先順位で減少した.
主要な成果:
- 290万件以上のFSAが分析され,減少率は13.1%でした.
- 女性では,リファレルの減少のリスクがより高かった (RR 1. 069).
- マオリ族 (RR 0.817) と太平洋民族 (RR 0.706) と若年/高齢の年齢層は減少リスクが低い.
- 減少リスクの地域と特異性の有意な変動が観察されました.
- 推薦率の全体的なリスクは,年間4. 1% (RR 1. 041) 増加した.
- マオリ族や太平洋地域以外の住民や貧困地域に住む人々のリスクは高かった.
結論:
- ニュージーランドでは,専門医による医療の需要が著しく増加しています.
- これらの傾向は 既存の健康格差を悪化させ プライマリケア資源を圧迫しています
- 専門医療へのアクセスにおける格差,特に高リスクの専門分野と集団の格差に対処するために,緊急の政策介入が必要である.
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