Abstract：
Introduction The pursuit of health care equity is a fundamental objective for Aotearoa New Zealand, and patient co-payments in primary care challenge this goal. Aim This study aimed to investigate the relationship between primary health care co-payments and the sociodemographic variables in areas where general practices provide health care. Methods Using census data, facilities information from the Ministry of Health, and socioeconomic deprivation indices, linear regression models were used to explore the relationship between weighted average fees charged by general practices and various sociodemographic variables in statistical area 2 regions. Results The study finds that areas with higher proportions of males and economically deprived individuals are associated with lower weighted average fees. Conversely, areas with higher proportions of retirement-aged and European individuals are linked with higher weighted average fees. The inclusion of the Very-Low-Cost-Access variable, indicating a subsidy scheme at the general practice level, made all the sociodemographic variables practically insignificant, suggesting Very-Low-Cost-Access practices are in the right geographical location to target high needs groups. Discussion The findings affirm the complexity of health care inequities in Aotearoa New Zealand, influenced not only by financial factors but also by demographic variables as they play out geographically. While subsidy schemes like the Very-Low-Cost-Access scheme appear to reach groups with greater need, a high level of unmet need due to cost suggests that the fees are still too high. Policymakers need to consider disparities in the on-going health care reforms and make further changes to subsidy schemes to reduce unmet need.
摘要：
引言追求医疗保健公平是新西兰奥特罗阿的基本目标，初级保健中的患者自付费用挑战了这一目标。目的本研究旨在调查一般做法提供医疗保健的地区的初级医疗保健共同支付与社会人口统计学变量之间的关系。方法利用人口普查数据，卫生部提供的设施信息，和社会经济剥夺指数，使用线性回归模型来探索按一般做法收取的加权平均费用与统计区2地区各种社会人口统计学变量之间的关系.结果研究发现，男性和经济贫困人群比例较高的地区与较低的加权平均费用相关。相反，退休年龄和欧洲个人比例较高的地区与较高的加权平均费用有关。包含极低成本访问变量，表明一般实践层面的补贴计划，使所有的社会人口统计学变量几乎无关紧要，建议低成本访问实践位于正确的地理位置，以针对高需求群体。讨论调查结果肯定了新西兰奥特罗阿医疗保健不平等的复杂性，不仅受金融因素的影响，而且受人口变量在地理上发挥作用的影响。虽然像极低成本访问计划这样的补贴计划似乎能够接触到更有需求的群体，由于成本原因，大量未满足的需求表明费用仍然过高。政策制定者需要考虑正在进行的医疗改革中的差距，并进一步改变补贴计划，以减少未满足的需求。
