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Primary Health Care Access and Ambulatory Sensitive Hospitalizations in New Zealand

Milne, Barry John PhD; Parker, Karl MSc; McLay, Jessica MSc; von Randow, Martin MSc; Lay-Yee, Roy MA; Hider, Phil MMedSci; Cumming, Jacqueline PhD; Davis, Peter PhD

Journal of Ambulatory Care Management: April/June 2015 - Volume 38 - Issue 2 - p 178–187
doi: 10.1097/JAC.0000000000000057
Original Articles

Ambulatory sensitive hospitalizations (ASH) are those thought to be preventable by timely and effective primary health care. Better access to primary health care has been associated with lower ASH rates. Funding increases to primary health care in New Zealand beginning in 2001 led to an improvement in access. Analysis of hospitalizations to all New Zealand public hospitals revealed that, for most age groups, ASH rates did not show long-term reductions from 2001 to 2009, while socioeconomic differences in ASH rates widened across this period. We conclude that increasing funding and access to primary health care will not, by itself, reduce ASH rates.

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Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand (Drs Milne and Davis, Ms McLay, and Messrs von Randow and Lay-Yee,); Social and Health Outcomes Research and Evaluation Centre (SHORE), Massey University, Auckland, New Zealand (Mr Parker); Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand (Dr Hider); and Health Service Research Centre, Victoria University, Wellington, New Zealand (Dr Cumming).

Correspondence: Barry John Milne, PhD, Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand (

This work was supported by the Health Research Council of New Zealand (grant number 08-089 C).

The authors thank Edward Griffin from the New Zealand Ministry of Health for access to the population data set, and Michelle van der Raaij from the Service Integration and Development Unit for help with classifying ambulatory sensitive hospitalizations.

No authors have any conflicts of interest to declare.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

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