Survey of Porirua patients shows more GP funding needed for high needs

Report from RNZ
More funding is needed for general practices that serve patients with high needs. A study of more than 4700 patients at a Porirua practice found a quarter had been diagnosed with diabetes or prediabetes.

Researchers examined the healthcare provided at the Porirua Union and Community Health Service in Cannons Creek, an area of high socioeconomic deprivation, over a 12-month period between April 2022 and March 2023.

Lead researcher Dr Christine Barthow from the University of Otago, Wellington, said one of the most striking findings was that people with prediabetes, like those with diabetes, often had a number of other long-term health conditions that needed to be managed.

“Prediabetes is often viewed as simply a risk state, but we found that many people already had complex health needs before diabetes was diagnosed,” she said.

Compared with people with normal blood sugar levels, those with prediabetes and diabetes used healthcare services more frequently.

People with diabetes had nearly twice as many consultations, three times as many prescriptions, and substantially higher rates of emergency department visits and potentially preventable hospital admissions.

The research was co-led by Porirua Union and Community Health Service GP Dr Bryan Betty.

Betty said government funding for primary healthcare needed to be better targeted to reflect the complexity and intensity of care required in communities with high-needs patients.

“Most of the healthcare for people with type 2 diabetes, prediabetes and multiple long-term conditions is provided through general practice, but these services are under increasing strain,” he said.

“The pressure is particularly acute in practices which serve mainly patients with greater clinical complexity or who experience socioeconomic deprivation.”

Betty said early diagnosis, consistent monitoring and timely intervention was important for patients with diabetes and those at risk of developing the disease.

Almost 350,000 New Zealanders have diabetes and this number is expected to rise to half a million by 2044.

Barthow said there were significant inequities in terms of the impact of diabetes on New Zealanders.

“People living in the most socioeconomically deprived areas are 2.7 times more likely to develop diabetes than those in the least deprived areas, and people of Pacific, Indian/South Asian, or Māori descent have a significantly higher incidence than those of European descent,” she said.

“Ensuring primary healthcare is properly funded to manage high-needs patients really is vital if we are to improve population health outcomes and reduce inequities.”

The research was funded by the Health Research Council and the results were published in the New Zealand Medical Journal.