Shortfalls of funding for general practice in deprived areas

Castle, Laura A.; Bradshaw, Melanie; Patel-Campbell, Thomas; Holmes, Michael V.; McEvoy, John W.

doi:10.3399/bjgp20x713357

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…This additional workload and complexity are not recognised or adequately supported by VLCA funding. Similar findings have been described in NZ [ 49 ] and internationally [ 50 ].…”

Section: Discussionsupporting

confidence: 91%

A multiple case study of pre-diabetes care undertaken by general practice in Aotearoa/New Zealand: de-incentivised and de-prioritised work

2023

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Background In Aotearoa/New Zealand (NZ) general practices diagnose and manage pre-diabetes. This work is important as it has the potential to delay or prevent the onset of Type 2 Diabetes (T2DM), reduce NZ’s health inequities, and the burden that T2DM places on health care services. However, no study has previously examined how this work routinely occurs in NZ. Methods Two case studies of practices serving ethnically and socio-economically diverse populations, followed by cross-case analysis. Results The NZ health care context including funding mechanisms, reporting targets, and the disease centred focus of care, acted together to dis-incentivise and de-prioritise pre-diabetes care in general practices. The social determinants of health differentially influenced patients’ ability to engage with and respond to pre-diabetes care, significantly impacting this work. Differing perspectives about the significance of pre-diabetes and gaps in systematic screening practices were identified. Interventions used were inconsistent and lacked comprehensive ongoing support. Conclusions Complex multi-layered factors impact on pre-diabetes care, and many of the barriers cannot be addressed at the general practice level. The practice serving the most disadvantaged population who concurrently have higher rates of pre-diabetes/T2DM were more adversely affected by the barriers identified.

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“…This additional workload and complexity are not recognised or adequately supported by VLCA funding. Similar findings have been described in NZ [ 49 ] and internationally [ 50 ].…”

Section: Discussionsupporting

confidence: 91%

A multiple case study of pre-diabetes care undertaken by general practice in Aotearoa/New Zealand: de-incentivised and de-prioritised work

2023

View full text Add to dashboard Cite

show abstract

“…Molokhia et al 1 report on chronic kidney disease (CKD) coding in primary care records in a multi-ethnic area of South London, demonstrating lower rates in all ethnic minority groups compared with the white population, which contributes to health inequalities. They also confirm the findings based on the National Chronic Kidney Disease audit 2,3 that absence of CKD coding is associated with worse outcomes for blood pressure management and statin prescribing, and is associated with a greater burden of non-steroidal anti-inflammatory drug (NSAID) prescribing.…”

Section: Inequalities In Ckd Management Can Be Overcomesupporting

confidence: 74%

“…The COVID pandemic has shone a spotlight on long recognised inequalities in health outcomes, 1 which have been widening in recent years. 2 Castle et al 3 describe how the general practice funding formula negatively impacts the ability of general practice teams to provide equitable care, with the risk of further widening these inequalities. The Health Foundation's recent report Level or Not?…”

Section: Gp Fundingmentioning

confidence: 99%

It’s time to look again at GP funding

Howell¹,

Torabi²

2020

Br J Gen Pract

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Shortfalls of funding for general practice in deprived areas

Cited by 2 publications

References 5 publications

A multiple case study of pre-diabetes care undertaken by general practice in Aotearoa/New Zealand: de-incentivised and de-prioritised work

A multiple case study of pre-diabetes care undertaken by general practice in Aotearoa/New Zealand: de-incentivised and de-prioritised work

It’s time to look again at GP funding

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