The enrolment gap and the COVID-19 pandemic: an exploration of routinely collected primary care enrolment data from 2016 to 2023 in Aotearoa New Zealand

Megan Pledger; Nisa Mohan; Pushkar Silwal; Maite Irurzun-Lopez

doi:10.1071/HC23128

RESEARCH ARTICLE (Open Access)

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The enrolment gap and the COVID-19 pandemic: an exploration of routinely collected primary care enrolment data from 2016 to 2023 in Aotearoa New Zealand

Megan Pledger

¹ ^* , Nisa Mohan ¹ , Pushkar Silwal ¹ , Maite Irurzun-Lopez ¹

+ Author Affiliations

- Author Affiliations

¹ Te Hikuwai Rangahau Hauora - Health Services Research Centre, Te Wāhanga Tātai Hauora - Wellington Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Rutherford House, Pipitea Campus, Bunny Street, Wellington 6011, New Zealand.

^* Correspondence to: megan.pledger@vuw.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 15(4) 316-323 https://doi.org/10.1071/HC23128

Submitted: 5 October 2023 Accepted: 23 November 2023 Published: 13 December 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

For many countries, primary health care (PHC) serves as the gateway for individuals to access healthcare services. It has been shown to not only improve health but also health equity. To maximise this benefit, a substantial proportion of the population needs to be connected with PHC. The aim here was to assess the degree and evolution of enrolment in light of the coronavirus disease 2019 (COVID-19) pandemic in Aotearoa New Zealand.

Methods

We examined data on the enrolment of people in PHC organisations between 2016 and 2023. This analysis included breakdowns by sex, age groups, ethnicity, and socioeconomic deprivation levels. Poisson regression models were used to explore whether enrolment changed because of the COVID-19 pandemic.

Results

In 2016, Māori, young people and the most deprived had lower enrolment rates relative to their peers. Although young people’s enrolment rate increased over time, especially during the COVID-19 pandemic, the Māori enrolment rate declined, as did the rate for Pacific people, and those who were the most deprived. The groups who had increases in enrolment rates were those with the lowest levels of socioeconomic deprivation and those in the ‘Other’ ethnic category, predominantly made up of European New Zealanders.

Conclusion

Enrolment statistics reveal disparities across sociodemographic lines. The COVID-19 pandemic was associated with changed patterns of enrolment that appear to have consequences for population health.

Keywords: Aotearoa New Zealand, COVID‐19, ethnic disparities, general practice, health equity, patient enrolment, primary health care, primary health organisation.

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