Association Between Barriers to Accessing General Practitioners and Emergency Department Visits in New Zealand
Author(s)
Yen Wei Lim, MSc (Pharmacoeconomics)1, Ross Wilson, PhD1, Rory Christopherson, MHSc. Rehab.1, Moody Gayed, MSc1, Richelle Caya, DPT1, Livia Gaspar Fernandes, MSc2, Andres Pierobon, MSc2, Yana Pryymachenko, PhD1, Dee Mangin, DPH3, J. Haxby Abbott, PhD1.
1University of Otago, Dunedin, New Zealand, 2University of Otago, Wellington, New Zealand, 3University of Otago, Christchurch, New Zealand.
1University of Otago, Dunedin, New Zealand, 2University of Otago, Wellington, New Zealand, 3University of Otago, Christchurch, New Zealand.
OBJECTIVES: The growth in the number of emergency department (ED) presentations has been a concern for health systems globally. Barriers to accessing general practitioners (GPs) may be associated with the use of ED. This study aims to investigate the associations between barriers to visiting GPs and the rate of ED visits in New Zealand (NZ).
METHODS: We used data from repeated waves of the New Zealand Health Survey, a large national survey of a representative sample of the NZ population, covering the years 2011 to 2022. Barriers were measured by whether a respondent reported that there was a time in which they had a health problem but did not visit a GP due to cost, lack of transport, waiting time to get an appointment, owing money to the practice, dislike of the GP, inability to get time off work, lack of care for dependent children, or lack of a supporter or interpreter. The association between each barrier and the number of visits to an ED was estimated by linear regression models, adjusting for age, gender, ethnicity, socioeconomic status, and health conditions.
RESULTS: Barriers to accessing GPs due to cost (adjusted mean difference 0.16 ED visits/year, 95%CI 0.14 to 0.17), lack of transport (0.50, 95%CI 0.46 to 0.53), waiting time to get an appointment (0.11, 95%CI 0.02 to 0.20), and owing money to the practice (1.39, 95%CI 1.14 to 1.63) were significantly associated with the number of visits made to an ED. Translating these findings to the NZ adult population, this represents potentially avoidable expenditures of NZ$50 million, NZ$37 million, NZ$31 million, and NZ$51 million, respectively.
CONCLUSIONS: Developing policies aimed at improving access to GP services may reduce ED visits and alleviate the personal, health system, and societal burden of avoidable ED use.
METHODS: We used data from repeated waves of the New Zealand Health Survey, a large national survey of a representative sample of the NZ population, covering the years 2011 to 2022. Barriers were measured by whether a respondent reported that there was a time in which they had a health problem but did not visit a GP due to cost, lack of transport, waiting time to get an appointment, owing money to the practice, dislike of the GP, inability to get time off work, lack of care for dependent children, or lack of a supporter or interpreter. The association between each barrier and the number of visits to an ED was estimated by linear regression models, adjusting for age, gender, ethnicity, socioeconomic status, and health conditions.
RESULTS: Barriers to accessing GPs due to cost (adjusted mean difference 0.16 ED visits/year, 95%CI 0.14 to 0.17), lack of transport (0.50, 95%CI 0.46 to 0.53), waiting time to get an appointment (0.11, 95%CI 0.02 to 0.20), and owing money to the practice (1.39, 95%CI 1.14 to 1.63) were significantly associated with the number of visits made to an ED. Translating these findings to the NZ adult population, this represents potentially avoidable expenditures of NZ$50 million, NZ$37 million, NZ$31 million, and NZ$51 million, respectively.
CONCLUSIONS: Developing policies aimed at improving access to GP services may reduce ED visits and alleviate the personal, health system, and societal burden of avoidable ED use.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD25
Topic Subcategory
Data Protection, Integrity, & Quality Assurance
Disease
No Additional Disease & Conditions/Specialized Treatment Areas