The significance of relational continuity of care for Māori patient engagement with predominantly non-Māori doctors: findings from a qualitative study.
OBJECTIVE
This qualitative study explored self-reported experiences of primary healthcare among a sample of urban Māori adults. This paper specifically focuses on the theme of relational continuity of care identified in participant discussions of access and engagement with their predominantly non-Māori general practitioners (GPs).


METHODS
The study involved a purposively selected subsample (n=42) of the Christchurch Māori cohort of the Hauora Manawa Community Heart Study (n=244). Participants took part in in-depth interviews, which were transcribed and analysed thematically.


RESULTS
Analysis identified compromised access to a preferred GP as a principal barrier to receiving quality and non-discriminatory care from predominantly non-Māori clinicians. In contrast to discussions of healthcare provided by usual GPs, episodic encounters with non-regular clinicians were commonly framed as experiences discouraging utilisation and the perceived value of primary healthcare.


CONCLUSIONS
Facilitating relational continuity of care for Māori patients and their clinicians may contribute towards mediating determinants of inequality at the clinical interface.


CONCLUSIONS
Reducing significant health disparities between Māori and non-Māori was a key goal of the reconfiguration of primary healthcare in the early 2000s. The role of relational continuity of care in achieving equitable inter-ethnic health outcomes in primary healthcare settings is an important consideration.
Christchurch School of Medicine, University of Otago, New Zealand.
Jennifer
J
Reid
Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, New Zealand.
Donna
D
Cormack
Christchurch School of Medicine, University of Otago, New Zealand.
Marie
M
Crowe
D000328:Adult; D015331:Cohort Studies; D003266:Continuity of Patient Care; D054521:Cultural Competency; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D036301:Qualitative Research; D014505:Urban Population
access; continuity of care; health disparities; primary healthcare; relational continuity