The enrolment gap: who is not enrolling with primary health organizations in Aotearoa New Zealand and what are the implications? An exploration of 2015–2019 administrative data

Abstract Background Primary Health Care (PHC) is the entry point to accessing health services in many countries. Having a high proportion of population enrolled with PHC provider key ensuring fulfils this role and that it contributes achieving better equity health. We aimed understand extent which people Aotearoa New Zealand are enrolling Organizations (PHOs), how enrolment rates have evolved over time, variations across District Boards (DHBs) socio-demographic groups. Methods analysed administrative data on PHOs breakdowns DHBs, by age, ethnicity deprivation, for years 2015–2019. Results About 6% was not 2019. There persistent differences groups as well geographically. M?ori lower than European/Other Young (15–24 years) least likely be enrolled. The most affluent areas highest rates. Auckland DHB shows lowest Conclusions Enrolments remain below full coverage inequities exist between geographic Potential reasons explaining these trends include methodological limitations real issues services. recommend (a) work towards minimising relation indicator improve its accuracy value signalling access services, (b) investigating potential widening identified, particular preventing younger from enrolling. This study deepens our understanding an tracking PHC. Other countries can learn case draw lessons improving care.