ArticleBMJ open2025
Quantifying unmet secondary healthcare need in New Zealand: a multi-year population study using administrative data.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Impact of Human Papillomavirus Primary Cervical Screening on Referral Rates and Outcomes for People Referred to Colposcopy for Clinical Reasons.The Australian & New Zealand journal of obstetrics & gynaecology · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesExamine patterns in declined referrals to secondary healthcare in New Zealand by sociodemographics, region, health specialty and over time, as an important marker of potential unmet healthcare need (UMN) for specialist care. The primary hypothesis was that UMN varies by sociodemographic groups, region and health specialty and has increased over time.
designA repeated cross-sectional analysis using administrative data from the National Patient Flow (NPF) Collection (2018-2022).
settingNationwide, encompassing all first specialist assessments (FSA) referrals to public hospital specialists in New Zealand.
participantsIndividuals referred by general practitioners for FSA. OUTCOME MEASURE: The primary outcome was FSA referrals being declined at prioritisation.
resultsAmong 2 918 557 first referrals for FSA, the observed rate of declined at prioritisation was 13.1%. Among those referred, females had a significantly higher risk of being declined (relative risk (RR), 1.069; 95% CI, 1.062 to 1.075), while those in younger (0-9 years: RR, 0.853; 95% CI, 0.841 to 0.865 and 10-19 years: RR, 0.891; 95% CI, 0.879 to 0.904) and older (80+years: RR, 0.955; 95% CI, 0.944 to 0.967) age groups as well as Māori (RR, 0.817; 95% CI, 0.810 to 0.824) and Pacific peoples (RR, 0.706; 95% CI, 0.695 to 0.716) had a significantly lower risk. There was also significant variation in risk of being declined by region and health specialty. The overall risk of being declined increased by 4.1% annually (RR, 1.041; 95% CI, 1.039 to 1.044). Significant increases in risk of declined over time were also observed across all sociodemographic groups, with higher risks for non-Māori/non-Pacific individuals (RR, 1.045; 95% CI, 1.043 to 1.048) and those in less deprived areas (RR, 1.057; 95% CI, 1.052 to 1.063).
conclusionsUMN in New Zealand has significantly increased, exacerbating health inequities and straining primary care. Policy interventions are urgently needed to address these disparities, particularly in high-risk specialties and populations. This method of quantifying an important marker of UMN may inform global health equity initiatives.
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