Abstract
General Practitioner (GP) shortages are an international problem. NZ is simultaneously experiencing an increase in GP demand due to a rising chronic health burden and a decrease in GP supply due to problems with recruitment, retention and retirement. This study used a mixed methods research methodology, mixing qualitative Action Research principles with quantitative analysis. These methods were applied to data collected on the location of 1064 general practices, 186 teaching practices and 495 medical students’ origin in order to determine the feasibility of utilising GIS technology in primary care research. This geographic data was combined with demographic data from the 2013 census in a GIS database to analyse for factors related to need and supply of general practice services. The network analysis has produced the most current and up-to-date picture of general practice accessibility in New Zealand. The data resulting from these analysis comprises of general practices or ‘points of supply’, linked to thirty-minute service area polygons containing 2013 census demographic information including the NZDep Score. This method has shown that physical accessibility to general practices varies considerably throughout New Zealand but that inaccessibility in the South Island of NZ is related more to rurality than socio-economic disadvantage. Urbanisation of both population and health services is having a marked effect upon accessibility for rural regions. However the presence of clinics in rural areas is reducing the shortage of medical services and increasing the access of these populations to health professionals. The analysis of the teaching practice data showed that practices that are located within moderately to high deprivation areas were more likely to have trained students in 2014. This may have beneficial effects on GP shortages in high need areas as positive training exposure is linked to a higher likelihood of selecting General Practice as a speciality. The geographical origin of students is also associated with future career choices. This study found that the medical students were more likely to originate from the least deprived regions of NZ so exposure to high need communities is particularly important. GIS has much to offer primary care research, however its’ most effective use relies on an understanding of the software, its application to the NZ context and potential access to a specialist for assistance with data analysis.