Hauora Māori – Māori health: a right to equal outcomes in primary care

作者：Nicolette Sheridan, Rawiri McKree Jansen, Matire Harwood, Tom Love, Timothy Kenealy, The Primary Care Models Study Group, Nelson Aguirre-Duarte, Bruce Arroll, Carol Atmore, Jenny Carryer, Peter Crampton, Anthony Dowell, Tana Fishman, Robin Gauld, Karen Hoare, Gary Jackson, Ngaire Kerse, Debra Lampshire, Lynn McBain, Jayden MacRae, Jane Mills, John Øvretveit, Teuila Percival, Roshan Perera, Martín Roland, Debbie Ryan, Jacqueline Schmidt‐Busby, Tim Stokes, Maria Stubbe · 发表于：International Journal for Equity in Health · 年份：2024 · DOI：10.1186/s12939-023-02071-6 · 被引用次数：27 · 研究领域：Indigenous Health, Education, and Rights、Athletic Training and Education、Global Health Workforce Issues

BACKGROUND: For more than a century, Māori have experienced poorer health than non-Māori. In 2019 an independent Tribunal found the Government had breached Te Tiriti o Waitangi by "failing to design and administer the current primary health care system to actively address persistent Māori health inequities". Many Māori (44%) have unmet needs for primary care. Seven models of primary care were identified by the funders and the research team, including Māori-owned practices. We hypothesised patient health outcomes for Māori would differ between models of care. METHODS: Cross-sectional primary care data were analysed at 30 September 2018. National datasets were linked to general practices at patient level, to measure associations between practice characteristics and patient health outcomes. PRIMARY OUTCOMES: polypharmacy (≥ 55 years), HbA1c testing, child immunisations, ambulatory sensitive hospitalisations (0-14, 45-64 years) and emergency department attendances. Regressions include only Māori patients, across all models of care. RESULTS: A total of 660,752 Māori patients were enrolled in 924 practices with 124,854 in 65 Māori-owned practices. Māori practices had: no significant association with HbA1c testing, ambulatory sensitive hospitalisations or ED attendances, and a significant association with lower polypharmacy (3.7% points) and lower childhood immunisations (13.4% points). Māori practices had higher rates of cervical smear and cardiovascular risk assessment, lower rate...