Primary healthcare utilisation among adults with mood and anxiety disorders: an analysis of the New Zealand Health Survey

Abstract

INTRODUCTION In New Zealand, as in other OECD countries, there is a high and growing prevalence of mental health problems, particularly anxiety and depression. These conditions are associated with a range of physical illnesses, and as a result this population have high and often complex needs for healthcare services, particularly through primary care. AIM To use data from the New Zealand Health Survey (NZHS) to examine the associations between internalising disorders (including anxiety, depression and bipolar disorder) and measures related to the utilisation of primary healthcare services. METHODS The study was based on responses from 13,719 adults who took part in the 2015-16 NZHS. Logistic regression analyses adjusted for sociodemographic variables were undertaken to examine the effect of having an internalising disorder on each measure related to primary healthcare utilisation. The strength of associations was indicated by odds ratios (ORs). RESULTS Adults with an internalising disorder were more likely to utilise primary health services (OR = 1.43-2.56, P < 0.001) compared to adults without an internalising disorder. However, they were more likely to have unmet needs due to cost or transport (OR = 2.45-3.38, P < 0.001), unfilled prescriptions due to cost (OR = 3.03, P < 0.001) and less likely to report positive experiences with general practitioners (OR = 0.67-0.79, P < 0.01). DISCUSSION Adults with internalising disorders require a higher level of support from primary healthcare, yet experience more barriers to accessing these services, and report less positive experiences with general practitioners. The NZHS may be a useful source of routinely collected data for understanding, monitoring and improving primary health service utilisation among people with internalising disorders.

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