Health complexity, metabolic health and service use in a high need primary care population in Aotearoa New Zealand: a cross-sectional study.

Authors

Christine Barthow, James Stanley, Bryan Betty, Dipan Ranchhod, Mara Coler, Nadine Kuiper, Erin Miller, Kelly Chonel, Eileen McKinlay, Jeremy Krebs

Published in

The New Zealand medical journal. Volume 139. Issue 1644. Pages 43-63. Oct 23, 2026. Epub Oct 23, 2026.

Abstract

The aim of this study was to understand the characteristics, health complexity and intensity of service provision for patients aged 16 years or older enrolled in a high-need practice.
This cross-sectional study used routinely collected data from an urban Very Low Cost Access practice serving a high-need population in Cannons Creek, Porirua, Aotearoa New Zealand. All patients aged ≥16 years enrolled for a 12-month period were included. Demographic, clinical, biological, medication and service use variables were extracted, and individuals were categorised into normoglycaemia, prediabetes and diabetes groups. Analyses used descriptive statistics, age-standardised rates and comparative assessments of health complexity and service utilisation.
The population (n=4,715) was predominantly Pacific, with most living in areas of high socio-economic deprivation and 25% classified with prediabetes or diabetes. Younger adults with diabetes had disproportionately high HbA1c and elevated albuminuria. Long-term conditions (LTCs), particularly obesity-related conditions, increased progressively across the glycaemic spectrum, with twofold to fourfold higher rates in dysglycaemia. Prediabetes and diabetes groups had similar LTC profiles. Service use increased with worsening dysglycaemia, with individuals with diabetes having nearly double the consultation rates, triple the prescription counts and markedly higher emergency department and ambulatory sensitive hospitalisation rates.
Dysglycaemia and multiple LTCs are common and resource-intensive in this population. Together, these data highlight the urgent need for proactive, well-resourced, equity-focussed primary care models to address metabolic risk, LTCs and high service demand.

PMID:
42912970
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.