National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study)

N Z Med J. 2011 Oct 14;124(1344):16-35.

Abstract

Introduction: Chronic illness is the leading cause of morbidity, mortality, and inequitable health outcomes in New Zealand. The ABCCNZ Stocktake aimed to identify extent of long-term conditions management evidence-based practices in stroke, cardiovascular disease, chronic obstructive pulmonary disease and congestive heart failure in New Zealand's District Health Boards (DHBs).

Methods: Eleven 'dimensions' of care for long-term conditions, identified by literature review and confirmed at workshops with long-term conditions professionals, formed the basis of the Stocktake of all 21 DHBs. It comprised two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing service provision.

Results: Fifteen DHBs completed all or parts of the questionnaires. Data accrual was completed in July 2008. Although most DHBs had developed long-term conditions management strategies to a moderate degree, there was considerable variability of practice between DHBs. DHBs thought their PHOs had developed strategies in some areas to a low to moderate level, though cardiovascular disease provision rated more highly. Regarding disease-specific services, larger DHBs had greater long-term conditions management provision not only of tertiary services, but of standard care, leadership, self-management, case-management, and audit.

Conclusions: There is considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual disease-specific service provision appears to relate to DHB size.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / therapy*
  • Chronic Disease
  • Disease Management
  • Evidence-Based Medicine
  • Health Care Surveys
  • Heart Failure / therapy
  • Humans
  • New Zealand
  • Primary Health Care / organization & administration*
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Regional Health Planning*
  • Stroke / therapy*