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Indicator 40: Specifically designed services

Indicator 40: Existence of primary health care services specifically designed for older persons
Indicator is fully reported? Yes.
Type of indicator Instrumental indicator Instrumental indicator
Other relevant indicators Data is available about the accessibility of existing services and whether services are culturally appropriate.
Our findings

This indicator is about having primary health services that:

  • employ staff who have expertise to care for older people;
  • are accessible to older people; and
  • are culturally appropriate.

Access to primary health care services is important for the good health and well-being of older people.

Expertise to care for older persons

The Accident Compensation Corporation (ACC) has identified that its older clients may need extra help and its National Serious Injury Service has employed co-ordinators to work with older clients. These co-ordinators are expected to have expertise in communicating with older clients and/or their advocates, be aware of available community support, facilitate retirement planning, and be aware of the diseases of ageing and their potential effect on injury recovery and rehabilitation.

Most primary health services care for people of all ages.[1] The Royal New Zealand College of General Practitioners is the professional body that provides training and professional development for general practitioners (and rural hospital generalists) and sets standards for general practice. General practitioners are trained to diagnose and treat a wide range of diseases, including those commonly experienced by older people.

Accessibility of services to older people

The New Zealand Health Survey[2] collects data on the accessibility of services for people of all ages. Our report on indicator 27 gives data on cost as a barrier to access for people aged 65+.

The Ministry of Social Development (MSD) uses data from the survey to report on relevant indicators on the New Zealand Positive Ageing Strategy.[3] The indicators are listed in Figure 1. Some of MSD’s indicators do not focus on older people (they measure access by people aged 15+). Other indicators use one definition of older people for Māori (age 50+) and another for non-Māori (65+). MSD states that it has done this because Māori have a shorter life expectancy. The indicators do not set out a standard of access that would be considered acceptable for older people compared to other age groups.

Culturally appropriate services

Over the years, training and resources have been provided to improve the cultural accessibility of services. Examples of some of the resources available include:

  • Medical Council of New Zealand (2006), Best health outcomes for Māori: Practice implications, www.mcnz.org.nz.
  • Nursing Council of New Zealand (2011), Guidelines for cultural safety, the Treaty of Waitangi, and Māori health in nursing education and practice, www.nursingcouncil.org.nz.
How entities use the data To improve the quality and accessibility of services.
Entity responsible for this indicator Ministry of Health (lead) and Accident Compensation Corporation.

Figure 1:
Positive Ageing Strategy indicators for primary health services

For Goal 2 – primary health care service use by older people For Goal 6 – a range of culturally appropriate services allow choices for older people
  • The proportion of people aged 15 years and over reporting having a usual health care practitioner.
  • The proportion of people aged 15 years and over whose usual health practitioner is a general practitioner (GP).
  • The proportion of people aged 15 years and over who saw a GP in the last 12 months
  • The proportion of people aged 15 years and over who did not see a GP in the last 12 months because of cost.
  • The proportion of people aged 15 years and over who did not collect prescriptions in the past 12 months because of cost.
  • The proportion of older Māori reporting having a usual health care practitioner, and whose usual health practitioner is a general practitioner (GP).
  • The proportion of older Māori who saw a GP in the last 12 months those who had an unmet need for a GP and those who had uncollected prescriptions in the past 12 months.
  • The proportion of older Māori who usually go to a Māori primary health care provider first when feeling unwell or injured.

[1] Some exceptions are primary health services for youth.

[2] The Ministry of Health reports the results of each survey at www.health.govt.nz.

[3] The New Zealand Positive Ageing Strategy (2001) is available at www.msd.govt.nz, along with reports on progress against each indicator.

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