Holes in the safety net? Assessing the effects of targeted benefits upon the health care utilization of poor New Zealanders

Citation
Jr. Barnett et al., Holes in the safety net? Assessing the effects of targeted benefits upon the health care utilization of poor New Zealanders, HEAL SOC C, 8(3), 2000, pp. 159-171
Citations number
86
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public Health & Health Care Science
Journal title
HEALTH & SOCIAL CARE IN THE COMMUNITY
ISSN journal
0966-0410 → ACNP
Volume
8
Issue
3
Year of publication
2000
Pages
159 - 171
Database
ISI
SICI code
0966-0410(200005)8:3<159:HITSNA>2.0.ZU;2-X
Abstract
This paper examines the issue of targeting primary health-care benefits in favour of low-income recipients and other high users of health care. Specif ically we examine the New Zealand case where, despite the introduction of s uch benefits in 1992, financial barriers appear to remain a significant det erminant of utilization. We address this issue through a case study conduct ed in the city of Christchurch. Through a survey-based research design, we seek to determine the extent to which price barriers remain important by co mparing patient utilization of a free community health clinic (n = 202) wit h a low-income control sample of patients who continue to use conventional (for New Zealand) fee-for-service providers (n = 148). We found that a larg e proportion of respondents delayed seeking care because of cost. Further,f or respondents using the fee-for-service providers, levels of use were not related to need, whereas at the free clinic there was an inverse relationsh ip between income and consultation rates. We conclude that if a universalit y of benefits is not possible, then there is a need for better targeting of primary care benefits. We believe there is a danger in such. initiatives b eing evaluated primarily in terms of their validity as funding mechanisms, rather than in terms of their success in meeting the health-care needs of t he disdavantaged.