title: New Zealand evidence for the impact of primary healthcare investment in Capital and Coast District Health Board.
abstract: OBJECTIVE
  This paper provides New Zealand evidence on the effectiveness of primary care investment, measured through the Capital and Coast District Health Board's (DHB) Primary Health Care Framework. The Framework was developed in 2002/2003 to guide funding decisions at a DHB level, and to provide a transparent basis for evaluation of the implementation of the Primary Health Care Strategy in this district.
  
  
  METHODS
  The Framework used a mixed method approach; analysis was based on quantitative and qualitative data.
  
  
  CONCLUSIONS
  This article demonstrates the link between investment in primary health care, increased access to primary care for high-need populations, workforce redistribution, and improved health outcomes. Over the study period, ambulatory sensitive hospitalisations and emergency department use reduced for enrolled populations and the District's immunisation coverage improved markedly. Funding and contracting which enhanced both 'mainstream' and 'niche' providers combined with community-based health initiatives resulted in a measurable impact on a range of health indicators and inequalities.  Maori primary care providers improved access for Maori but also for their enrolled populations of Pacific and Other ethnicity. Growth and redistribution of primary care workforce was observed, improving the availability of general practitioners, nurses, and community workers in poorer communities.
authors.affiliation: Capital and Coast DHB, Wellington, New Zealand. lttan9988@gmail.com
authors.forename: Lee
authors.initials: L
authors.lastname: Tan
authors.forename: Julia
authors.initials: J
authors.lastname: Carr
authors.forename: Johanna
authors.initials: J
authors.lastname: Reidy
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration; D017598:Efficiency, Organizational; D005376:Financial Management / Q000706:statistics & numerical data*; D018166:Health Care Reform / Q000191:economics; D006293:Health Promotion / Q000191:economics* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006303:Health Services, Indigenous / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007449:Investments / Q000706:statistics & numerical data; D009520:New Zealand; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D035862:Vulnerable Populations / Q000706:statistics & numerical data