Many organisations delivering health services throughout New Zealand communities say they are at risk and working to capacity, new research shows.
Primary Health Organisations were created six years ago under major health reforms introduced by the previous Labour-led government.
About 80 were established to plan, fund and co-ordinate health services in the community.
Researchers from the Health Services Research Centre at Victoria University have been monitoring reforms over the past several years designed to lift overall standards of health.
The researchers say it costs less to see the doctor now, and more people are going, but the little-understood PHOs underpinning the service are fragile.
The PHOs vary in size, from those covering less than 4000 people to those with enrolled populations of more than 350,000.
Sixteen percent of PHOs feel at risk and just 41% consider themselves to be doing well, the study shows.
Researchers say the PHOs are a relatively fragile, complex set of organisations facing significant challenges and believe it is time to revist the role of PHOs to assess whether they can achieve what is expected of them.
It has previously been suggested PHOs need stronger management systems and may need to amalgamate to achieve that.