ArticleBMJ open2019
Improving access to health care for people with severe chronic obstructive pulmonary disease (COPD) in Southern New Zealand: qualitative study of the views of health professional stakeholders and patients.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- What Is Known About Family-Inclusive Inpatient Care From Patient and Family Perspectives? An Integrative Review.Journal of advanced nursing · 2025Pooled it
- Decoding Diagnostic Delay in COPD: An Integrative Analysis of Missed Opportunities, Clinical Risk Profiles, and Targeted Detection Strategies in Primary Care.Diagnostics (Basel, Switzerland) · 2025Article
- Beyond Smoking: Emerging Drivers of COPD and Their Clinical Implications in Low- and Middle-Income Countries: A Narrative Review.Journal of clinical medicine · 2025Review
- A qualitative study of rural healthcare providers' views of social, cultural, and programmatic barriers to healthcare access.BMC health services research · 2022Article
- Article
- Barriers and Enablers to Pulmonary Rehabilitation in Low- and Middle-Income Countries: A Qualitative Study of Healthcare Professionals.International journal of chronic obstructive pulmonary disease · 2022Article
- Factors affecting healthcare pathways for chronic lung disease management in Vietnam: a qualitative study on patients' perspectives.BMC public health · 2021Article
- A Real-World Analysis of Treatment Patterns and Clinical Characteristics Among Patients with COPD Who Initiated Multiple-Inhaler Triple Therapy in New Zealand.International journal of chronic obstructive pulmonary disease · 2021Article
- Patients' accounts of living with and managing inflammatory bowel disease in rural Southern New Zealand: a qualitative study.BMJ open · 2020Article
- Stakeholders' Perspectives on the Quality of End-of-Life Health Care Services for Chronic Obstructive Airways Disease: A Focus Group Study.International journal of integrated careArticle
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesChronic obstructive pulmonary disease (COPD) is a common chronic disease with significant morbidity and mortality, particularly for Māori, which places a large burden on the New Zealand (NZ) health system. We undertook a qualitative study as part of a mixed-methods implementation research project which aimed to determine the barriers and enablers to the provision of accessible high-quality COPD care.
settingSouthern Health Region of NZ (Otago and Southland).
participantsThirteen health professional stakeholders and 23 patients with severe COPD (including one Māori and one Pasifika participant).
methodsSemistructured interviews were undertaken. A thematic analysis using the Levesque conceptual framework for access to healthcare was conducted.
resultsHealth professional stakeholders identified barriers to providing access to health services, in particular: availability (inadequate staffing and resourcing of specialist services and limited geographical availability of pulmonary rehabilitation), affordability (both of regular medication, medication needed for an exacerbation of COPD and the copayment charge for seeing a general practitioner) and appropriateness (a shared model of care across primary and secondary care was needed to facilitate better delivery of key interventions such as pulmonary rehabilitation and advance care planning (ACP). Māori stakeholders highlighted the importance of communication and relationships and the role of whānau (extended family) for support. Patients' accounts showed variable ability to access services through having a limited understanding of what COPD is, a limited knowledge of services they could access, being unable to attend pulmonary rehabilitation (due to comorbidities) and direct (medication and copayment charges) and indirect (transport) costs.
conclusionsPeople with severe COPD experience multilevel barriers to accessing healthcare in the NZ health system along the pathway of care from diagnosis to ACP. These need to be addressed by local health services if this group of patients are to receive high-quality care.
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