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Health care delivery, models of care, health professionals working together.

Current research in this area includes:

Clinical Practice Variation

Tony Dowell

The Power Law:Hallmark Of A Complex System
Science and Style:A Study Of Medical Practice Variation Among General Practitioners

Direct to Consumer Advertising (DTCA)

Tony Dowell:

Toop L, Richards D, Dowell AC. The leadership role of general practice in public health: Advocating for a ban on direct to consumer advertising of prescription drugs in New Zealand. British Journal of General Practice 2003;53(4):342-345.

Toop L, Richards D, Dowell AC, Tilyard M, Fraser T, Arroll B. Direct to Consumer Advertising of Prescription Drugs in New Zealand: For Health or Profit? Christchurch: Christchurch School of Medicine; 2003

Integrated Secondary Specialist Service in Primary Care Team Diabetes Management

Ben Gray:

We developed a model of provision of specialist Diabetes care at Newtown Union Health Service. This consisted of a consultative clinic where patients were seen by the specialist along with the GP and nurse involved in their care. The clinic evolved such that more time was spent discussing cases (without the patient present) and it became clear that one of the most important outcomes of this initiative was educational rather than clinical; that the primary care staff became more able to manage the patients with diabetes without specialist input. This was a small pilot. The current HRC funded study under Dr Jeremy Krebs is evaluating this model of care after introducing it to Porirua Union and Community Health Service. This is an important initiative in trying to understand how to improve long term condition management and enable inter-professional practice.

Mystery Shopping in Health Services Evaluation

Helen Moriarty, Deborah McLeod, Tony Dowell

A collaborative study with BRC marketing and research to evaluate the Healthline telephone triage service using mystery shoppers calling with scripted clinical scenarios. Project funded by Ministry of Health.

Moriarty H, McLeod D, Dowell A. Mystery shopping in health service evaluation. Br J Gen Pract 2003:53 (497). 942-946

Screening and Risk Project

Helen Moriarty :

Utilisation of Primary Health Care: analysis of routinely collected data (HURA)

Tony Dowell, Donna Cormack, Deborah McLeod, Bridget Robson, Peter Crampton, Clare Salmond

A collaborative study with the Te Ropu Rangahau Hauora a Eru Pomare, Department of Public Health, Wellington Independent Practitioners' Association.In 2001 routinely-collected data were extracted from 26 general practices in Wellington as part of the HRC funded HURA Study. Analysis of this data for registered patients has demonstrated an increasing rate of doctor consultations with increasing deprivation. Comparison of consultations for the under-six and six-and-over age groups suggested that despite the trend for increasing rates with increasing deprivation cost remained a barrier to general practice consultation in 2001. There were also a substantial number of casual doctor consultations. In contrast to doctor consultations, there was a decreasing rate of nurse consultations with increasing deprivation. Since 2001 there has been considerable change in the primary care sector in New Zealand with many changes explicitly targeted at improving access. The HURA research team would like to collect 2005 data from Wellington general practices and compare enrolment, utilisation and management of specific diseases before and after the formation of Primary Health Organisations.

HURA resources are available for use with acknowledgement of the HURA research team:

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