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Future health systems will be required to accommodate changing social and treatment environments along with new and not-before-contemplated health care roles. Thus, health workforce planning is likely to benefit from improved problem identification, response formulation and data and methods that provide deeper understandings of socially influenced systems. Actor analysis is able to facilitate this through its examination of actor goals, interactions, and influences. We explore the use of this infrequently reported method in the context of health workforce planning. Through an embedded mixed methods design, we draw on data from inductive document analysis, deductively coded semi-structured interview responses from two separate but interconnected health sub sectors and numerically transform these to comply with the selected actor analysis software’s input requirements. Our findings underline the importance of actor analysis as an investigative resource for delineating actor positions on a range of strategic issues pertinent to health workforce futures to reveal a different perspective of the system’s evolution than that derived from conventional health workforce forecasting methods. A hierarchy of critical issues and the influential actors that hold sway over the workforce discourse are found, providing some insight into why conventional workforce plans can provide less than expected results. [ABSTRACT FROM AUTHOR]

Primary health care policies in New Zealand, as in many countries, have focused on reducing barriers to access. Financial barriers to obtaining timely health care, while not the only important barriers, are amongst the most important, and are amenable to policy reforms. There is little robust empirical evidence about the extent to which cost related barriers are associated with adverse health outcomes. Past evidence is limited to cross-sectional studies of selected groups, selected primary health care services, and to cross-sectional studies that are susceptible to unmeasured confounding bias. Using fixed effects regression modelling and data from 17,363 participants with at least two observations in three waves (2004–05, 2006–07, 2008–09) of the SoFIE-Health panel data, this study examines the impact of financial barriers to access to primary health care (general practitioner and dentist) on health status using a longitudinal national panel study of adult New Zealanders. Self-rated health (SRH), physical health (PCS) and mental health summary scores (MCS) were the health measures. The two exposures were: not seeing 1) the doctor and 2) the dentist because of cost at least once during the preceding 12 months. We also tested for interactions between the exposure (deferral of care) and age, gender, ethnicity and three health outcomes. For all outcomes, after adjusting for time-varying confounders, health deteriorated as the number of waves increased in which a non-visit was reported. Moreover, the effect size for any health deterioration was greater for deferring a dentist visit than for deferring a physician visit. Except gender and age (for MCS and doctor visits), and gender and ethnicity (for SRH and dentist visits) we did not find any evidence of interactions. These results support policy responses focussed on decreasing financial barriers to access. In the New Zealand context this finding is particularly important for dental care. • Cost barriers to access to primary care lead to a decrease in self-rated health. • The health impact was greater for deferring a dentist visit than a physician visit. • Cost barriers to doctor visits affected the mental health of males and young adults. • Cost barriers to dentist visits affected the health of males and Pacific people. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this research was to identify a small set of indicators of an individual''s deprivation that is appropriate for all ethnic groups and can be combined into a single and simple index of individual socioeconomic deprivation in New Zealand. The NZiDep index of socioeconomic deprivation was derived using the same theoretical basis as the national census-based small-area indices of relative socioeconomic deprivation. The index has been created and validated from the analysis of representative sample survey data obtained from approximately 300 Maori, 300 Pacific, and 300 non-Maori, non-Pacific adults. Twenty-eight deprivation-related characteristics, derived from New Zealand and overseas surveys, were analysed by standard statistical techniques (factor analysis, Cronbach''s coefficient alpha, item-total correlations, principal component analysis). The index was validated using information on tobacco smoking, which is known to be strongly related to deprivation. The NZiDep index is based on eight simple questions which take 2–3min to administer. The index is a significant new (non-occupational) tool for measuring socioeconomic position for individuals. We argue that the index has advantages over existing measures, including a specific focus on deficits, applicability to all adults (not just the economically active), and usefulness for all ethnic groups. Its strengths include focus, simplicity, utility, acceptability across ethnic groups, construct validity, statistical validity, criterion validity (measured with reference to tobacco smoking), and relevance to the current New Zealand context. The index is indicative of deprivation in general, and is designed for use as a variable in research, and for elucidating the relationships between socioeconomic position and health/social outcomes. [Copyright &y& Elsevier]

Focuses on the development of third sector primary care for vulnerable populations in the Netherlands. Participation of the medical sector in community services; Measurement of socioeconomic deprivation of registered patients; Quality of services.

Healthcare systems can be considered moral economies in which moral capital in the form of expectations toward norms, values, and virtues are exchanged and traded. Moral capital, as a concept, is an extension of Bourdieu's forms of symbolic, and in particular, cultural capital. This research set out to identify forms of moral capital evident in the accounts of health professionals and patients within the distinctive healthcare systems of Germany, New Zealand, and the Unites States. Here, we provide an overview of 15 forms of moral capital that were identified. An important form of moral capital is equality. The global coronavirus pandemic has illuminated inequalities in healthcare systems across the world. We suggest considering moral capital as a useful tool to reform healthcare systems and make the provision of healthcare a more equitable enterprise. • Healthcare systems can be considered moral economies in which moral capital is traded. • The authors identified 15 forms of moral capital in Germany, New Zealand, and the Unites States. • Forms of moral capital include equality, trust, and solidarity, among others. • Moral capital can be a useful tool to reform healthcare systems. [ABSTRACT FROM AUTHOR]