Hospital services utilisation in New Zealand: findings from the New Zealand health surveys 1996/97 and 2002/03

Abstract

This thesis investigates the use of hospital services in New Zealand. This is carried out through an analysis of the New Zealand Health Surveys (NZHS) which were undertaken by the Ministry of Health in 1996/97 and 2002/03. The main focus is on the 2002/03 NZHS. Public hospital services are freely available to all New Zealanders. Identifying population groups that have a higher likelihood of using hospital services and the difference between users of the different types of hospital services may allow more targeted health initiatives can be made to reduce hospitalisations amongst these groups. The results of the 2002/03 NZHS showed that 22.2% (21.1-23.3) of New Zealanders used a public hospital in the previous 12 months. The rates of utilisation of private hospital services and private A&E and doctors after hours clinic services are 6.1% (5.5-6.6) and 13.1% (12.2-14.1) respectively. The results also showed that health status has a strong association with all forms of public hospital service use. Public A&E services had no association with enabling factors, whereas private services had strong association with enabling factors such as high income. An additional component of this research is an investigation into the jackknife and bootstrap variance estimation methods use in complex surveys such as the NZHS. These techniques were found to have limitations in some situations, for example location based variables affected by small sample sizes, however they are computationally simple to apply.