Availability and structure of primary medical care services and population health and health care indicators in England
<p>Abstract</p> <p>Background</p> <p>It has been proposed that greater availability of primary medical care practitioners (GPs) contributes to better population health. We evaluated whether measures of the supply and structure of primary medical services are associated...
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| Format: | Article |
| Language: | English |
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BMC
2004-06-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://www.biomedcentral.com/1472-6963/4/12 |
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| author | Adams Geoffrey Jack Ruth H Gulliford Martin C Ukoumunne Obioha C |
| author_facet | Adams Geoffrey Jack Ruth H Gulliford Martin C Ukoumunne Obioha C |
| author_sort | Adams Geoffrey |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>It has been proposed that greater availability of primary medical care practitioners (GPs) contributes to better population health. We evaluated whether measures of the supply and structure of primary medical services are associated with health and health care indicators after adjusting for confounding.</p> <p>Methods</p> <p>Data for the supply and structure of primary medical services and the characteristics of registered patients were analysed for 99 health authorities in England in 1999. Health and health care indicators as dependent variables included standardised mortality ratios (SMR), standardised hospital admission rates, and conceptions under the age of 18 years. Linear regression analyses were adjusted for Townsend score, proportion of ethnic minorities and proportion of social class IV/ V.</p> <p>Results</p> <p>Higher proportions of registered rural patients and patients ≥ 75 years were associated with lower Townsend deprivation scores, with larger partnership sizes and with better health outcomes. A unit increase in partnership size was associated with a 4.2 (95% confidence interval 1.7 to 6.7) unit decrease in SMR for all-cause mortality at 15–64 years (P = 0.001). A 10% increase in single-handed practices was associated with a 1.5 (0.2 to 2.9) unit increase in SMR (P = 0.027). After additional adjustment for percent of rural and elderly patients, partnership size and proportion of single-handed practices, GP supply was not associated with SMR (-2.8, -6.9 to 1.3, P = 0.183).</p> <p>Conclusions</p> <p>After adjusting for confounding with health needs of populations, mortality is weakly associated with the degree of organisation of practices as represented by the partnership size but not with the supply of GPs.</p> |
| first_indexed | 2024-12-20T00:28:23Z |
| format | Article |
| id | doaj.art-16a8096eef194ff7acf2ace40209c45b |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-20T00:28:23Z |
| publishDate | 2004-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-16a8096eef194ff7acf2ace40209c45b2022-12-21T20:00:00ZengBMCBMC Health Services Research1472-69632004-06-01411210.1186/1472-6963-4-12Availability and structure of primary medical care services and population health and health care indicators in EnglandAdams GeoffreyJack Ruth HGulliford Martin CUkoumunne Obioha C<p>Abstract</p> <p>Background</p> <p>It has been proposed that greater availability of primary medical care practitioners (GPs) contributes to better population health. We evaluated whether measures of the supply and structure of primary medical services are associated with health and health care indicators after adjusting for confounding.</p> <p>Methods</p> <p>Data for the supply and structure of primary medical services and the characteristics of registered patients were analysed for 99 health authorities in England in 1999. Health and health care indicators as dependent variables included standardised mortality ratios (SMR), standardised hospital admission rates, and conceptions under the age of 18 years. Linear regression analyses were adjusted for Townsend score, proportion of ethnic minorities and proportion of social class IV/ V.</p> <p>Results</p> <p>Higher proportions of registered rural patients and patients ≥ 75 years were associated with lower Townsend deprivation scores, with larger partnership sizes and with better health outcomes. A unit increase in partnership size was associated with a 4.2 (95% confidence interval 1.7 to 6.7) unit decrease in SMR for all-cause mortality at 15–64 years (P = 0.001). A 10% increase in single-handed practices was associated with a 1.5 (0.2 to 2.9) unit increase in SMR (P = 0.027). After additional adjustment for percent of rural and elderly patients, partnership size and proportion of single-handed practices, GP supply was not associated with SMR (-2.8, -6.9 to 1.3, P = 0.183).</p> <p>Conclusions</p> <p>After adjusting for confounding with health needs of populations, mortality is weakly associated with the degree of organisation of practices as represented by the partnership size but not with the supply of GPs.</p>http://www.biomedcentral.com/1472-6963/4/12primary health caresocio-economic inequalitiesaccess to medical carehospital utilisationsocial justice |
| spellingShingle | Adams Geoffrey Jack Ruth H Gulliford Martin C Ukoumunne Obioha C Availability and structure of primary medical care services and population health and health care indicators in England BMC Health Services Research primary health care socio-economic inequalities access to medical care hospital utilisation social justice |
| title | Availability and structure of primary medical care services and population health and health care indicators in England |
| title_full | Availability and structure of primary medical care services and population health and health care indicators in England |
| title_fullStr | Availability and structure of primary medical care services and population health and health care indicators in England |
| title_full_unstemmed | Availability and structure of primary medical care services and population health and health care indicators in England |
| title_short | Availability and structure of primary medical care services and population health and health care indicators in England |
| title_sort | availability and structure of primary medical care services and population health and health care indicators in england |
| topic | primary health care socio-economic inequalities access to medical care hospital utilisation social justice |
| url | http://www.biomedcentral.com/1472-6963/4/12 |
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