Karo Data Management LogoKaro Data Management Logo

PHO utilisation

This spreadsheet is a summary of the average number of visits (utilisation) per patient by provider type, practice, ethnicity, age group and gender for your PHO. View a sample report (pdf 414kb) 

 

It is important to distinguish between the number of visits and the utilisation rate. The absolute number of visits lets you see how much of your time is spent with different patient groups so is a good representation of time spent. However, when doing comparisons between groups, it is important to standardise to a utilisation rate. Otherwise it is easy to make mistaken judgments about which patient groups are receiving more or less service.

It is also very important when analysing by ethnicity or quintile to make sure that comparisons are done by age group. This is because different populations can have very different age distributions.

Summary

This page is a brief summary of the utilisation information. On the right side of the page, there are  clickable links to each sheet except to the graphs (it is not possible to create a clickable link to a graph in Excel).

Utilisation

This shows the total number of GP visits, nurse/other visits and total visits for your patients for all the previous quarters. The visits counted are those defined by the MoH i.e. what would have been a 'GMS' type visit in the past. They exclude ACC, maternity, immunisation, scripts and administrative invoices. If your practices are not creating $0 invoices for no charge visits, such visits will NOT be included in these totals.

The number of visits is then divided by the total patients to give a utilisation rate for each quarter. The utilisation rate varies over time, in particular where there is substantial seasonal variation.

Utilisation graph

This is a graphical representation of the utilisation on  sheet 1. It shows the utilisation rate over time for your PHO. The graph makes it easier to see any seasonal variation and any trends over time.

Practice breakdown

This shows the total number of GP visits, nurse/other visits and total visits for your patients for each individual practice. If your practices are not creating invoices for zero charge visits, they will NOT be included in these totals.

The number of visits is then divided by the total patients to give a utilisation rate for each practice. When comparing practices, it is important to take into account any differences in the patient demographics and 'model of care'.

Practice graph

This is a graphical representation of the utilisation on sheet 3. It shows the utilisation rates for your practices. The graph makes it easier to see differences between practices.

High need: GP

This is a somewhat complicated piece of analysis. 

The top part of the table shows the patients, visits and utilisation rate for each age group: firstly for high needs patients (Maori, Pacific and Dep 5) and secondly for non-high needs patients. The utilisation rate for each age group is then weighted using the total NZ population in that age group. Then these two weighted utilisation rates are used to calculate the ratio of high needs utilisation to non-high needs  utilisation.

High need: nurse

This sheet is exactly the same as sheet 5 except that, instead of analysing GP visits, it analyses nurse/other visits.

Age group

This shows the total number of GP visits, nurse/other visits and the total visits for each age group. It is interesting to note that while the number of visits might be high in a particular age group, that doesn't always translate into a higher utilisation rate if you also have a high number of patients in that age group.

Age group graph

This is a graphical representation of the utilisation on sheet 7. Generally this graph will start in the middle (for under 5's), drop to the lowest points for the 5-14 and 15-24 age groups, rise a bit for the 25-45 age group, then depending on the nature of your population, rise quite a bit for the 45-64 age group (high Maori and Pacific populations rise more steeply) and then to the highest point for the 65 plus age group.

Quintile

This shows the total number of GP visits, nurse/other visits and the total visits for each quintile by age group. It is interesting to note that while the number of visits might be high for a particular quintile, that doesn't always translate into a higher utilisation rate if you also have a high number of patients in that quintile.

Quintile graph

This is a graphical representation of the utilisation on sheet 9. Generally you would expect to see a slightly higher rate of utilisation for your Q4 and Q5 patients compared to Q1 and Q2. However, if you have a small PHO, these trends may not be obvious.

Ethnic group

This shows the total number of GP visits, nurse/other visits and the total visits for each ethnic group by age group. It is important again to note that a high utilisation rate does not equate to high absolute numbers of visits, e.g., you may have a very small number of patients in a particular ethnic group but they may have a high utilisation rate.

What should be of concern is if it looks as though any ethnic group is 'missing out' within any of the age ranges.

It is also common for Maori and Pacific patients in the 45-64 age range to have higher utilisation rates due to the earlier onset of chronic conditions.

Ethnic group graph

This is a graphical representation of the utilisation on the previous sheet - the same comments apply.