What is the answer to the challenge of multimorbidity in New Zealand?
Anna Askerud
1 3 , Chrystal Jaye 1 , Eileen McKinlay 2 , Fiona Doolan-Noble 1
1 University of Otago, Department of General Practice and Rural Health, Dunedin, New Zealand.
2 Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
3 Corresponding author. Email: aaskerud@op.ac.nz
Journal of Primary Health Care 12(2) 118-121 https://doi.org/10.1071/HC20028
Published: 15 June 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
The increasing prevalence of multimorbidity, a growing ageing population and lack of success in addressing the negative effect of socioeconomic and cultural determinants of health are major challenges for New Zealand’s primary care sector. Self-management support strategies, personalised care planning, integrated care and shared health records have all been proposed as mechanisms to address these challenges. The organisation of the health system, however, remains largely unchanged, with limited accommodation and few funding concessions made for the requirements of these different approaches and tools. As a result, the primary care system is no longer a good match for the population it serves. With one in four New Zealanders reporting multimorbidity, and people aged >65 years predicted to double in number by 2050, this article argues that over the next decade, New Zealand requires a health system focused on incorporating self-management support, personalised and integrated care and shared health records. This will require further educating of not only health professionals, but also patients in the purpose behind these approaches. In addition, it will mean transitioning to a primary care system more suited to the needs of people with long-term conditions. The key gain from a radical redesign will be a more equitable health system focused on a broader range of health needs.
KEYwords: Multi-morbidity; primary care; chronic care model; person-centred care; equitable healthcare
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