The significance of relational continuity of care for Maori patient engagement with predominantly non-Maori doctors: findings from a qualitative study

Objective: This qualitative study explored self-reported experiences of primary healthcare among a sample of urban Maori adults. This paper specifically focuses on the theme of relational continuity of care identified in participant discussions of access and engagement with their predominantly non-Maori general practitioners (GPs). Methods: The study involved a purposively selected subsample (n=42) of the Christchurch Maori cohort of the Hauora Manawa Community Heart Study (n=244). Participants took part in in-depth interviews, which were transcribed and analysed thematically. Results: Analysis identified compromised access to a preferred GP as a principal barrier to receiving quality and non-discriminatory care from predominantly non-Maori clinicians. In contrast to discussions of healthcare provided by usual GPs, episodic encounters with non-regular clinicians were commonly framed as experiences discouraging utilisation and the perceived value of primary healthcare. Conclusions: Facilitating relational continuity of care for Maori patients and their clinicians may contribute towards mediating determinants of inequality at the clinical interface. Implications: Reducing significant health disparities between Maori and non-Maori was a key goal of the reconfiguration of primary healthcare in the early 2000s. The role of relational continuity of care in achieving equitable inter-ethnic health outcomes in primary healthcare settings is an important consideration.