TRENDS IN GENERAL-PRACTICE IN THE WAIKATO, 1979-80 1991-92, II - SOCIAL VARIATIONS IN-SERVICE USE AND CLINICAL ACTIVITY/

Aims. To document trends in ethnic group and occupational class differ ences in the use of general practitioner services and in patterns of c linical activity for the Hamilton Health District of the Waikato over the period 1979-80 to 1991-92. Methods. The data are drawn from a base line and a followup survey of general practice in the Waikato region r epresenting a one per cent sample of all in-surgery, in-hours, week-da y encounters at two points in time. The data were recorded by particip ating general practitioners in four collection weeks spaced over the p eriod of a year. In total, 9468 and 10 235 patient encounter forms wer e completed respectively. Results. Over a period in which service avai lability and rates of medical contact grew, there was a relatively gre ater increase in utilisation among Maori and lower socioeconomic group s: between the two surveys the ratio of Maori to non-Maori rates incre ased from 0.8 to 1.0 and the ratio of visits for lower to higher socio economic groups grew from a differential of 2.5 to one of 3.1. More se rious conditions apart;, these changes seemed to occur uniformly regar dless of the severity, amenability or susceptibility of the condition presented to the general practitioner. Changes in ethnic group and occ upational class patterns of service activity almost exactly mirrored t hese trends. Conclusions. A notable relative increase in rates of cont act for primary medical care among Maori and lower socioeconomic group s seems to have accompanied the growth in the 1980s of the availabilit y of general practitioner services in this region of New Zealand.