Author: Karolyn Kerr
The University of
New Zealand has a population of four million people spread over 270,000 square kilometres. Eighty five percent of the population are concentrated in the urban areas. The main ethnic groups are European 71%, indigenous Maori 14.5%, Pacific Islanders 4.8%, and Asian 4.5%. The cornerstone of New Zealand’s health system is public finance through taxes with access to health services based upon need. In New Zealand in 2000/01 $9.884 billion, including private funding, was spent on health and disability support services (NZ$2601 per capita). Of this, $2.3 billion (23.3 %) was privately funded and $7.584 billion (76.7 %) publicly funded (Ministry of Health, 2003b). Since 1999 the New Zealand Government has been moving away from market-based structures in the health sector, by combining the health care purchaser and provider functions into community-focused District Health Boards (DHBs) (Kerr, 2004). An illustration of the structure of the health sector is provided in Figure 2 below. Central government provides broad guidelines on what services the DHBs must provide, and national priorities have been identified in the New Zealand Health Strategy (Ministry of Health, 2000). A range of providers including public hospitals, non-profit health agencies, or private organisations can deliver services. Funding is allocated to DHBs using a weighted population based funding formula. DHBs are responsible for planning, funding and ensuring the provision of health and disability services to a geographically defined population. This reflects a move away from the previous purchaser/provider split, as DHBs provide hospital (and some community-based) services. DHBs are responsible for improving, promoting and protecting the health and independence of their populations. Boards must assess the health and disability support needs of the people in their regions, and manage their resources appropriately in addressing those needs. DHBs vary considerably in size. There are six tertiary DHBs and 14 secondary DHBs. The largest DHB provides services for 477,000 patients, with the smallest providing services for 30,300 (Ministry of Health, 2003a).
Keywords: Health Information Management, Health Structure, New Zealand Health Sector