Quantifying unmet need in General Practice: a retrospective cohort study of administrative data
Objectives To assess whether patients attending general practices (GPs) in socioeconomically (SE) deprived areas receive the same amount of care, compared with similar patients (based on age, sex and level of morbidity) attending GPs in less deprived areas. If not, to quantify the additional resourc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e068720.full |
| _version_ | 1797225042036129792 |
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| author | Alex McConnachie Philip Wilson Ross McQueenie David A Ellis Andrea E Williamson |
| author_facet | Alex McConnachie Philip Wilson Ross McQueenie David A Ellis Andrea E Williamson |
| author_sort | Alex McConnachie |
| collection | DOAJ |
| description | Objectives To assess whether patients attending general practices (GPs) in socioeconomically (SE) deprived areas receive the same amount of care, compared with similar patients (based on age, sex and level of morbidity) attending GPs in less deprived areas. If not, to quantify the additional resource that would be required by GPs in deprived areas to achieve parity.Design Retrospective cohort study.Setting 150 GPs in Scotland, UK, divided into two groups: 80 practices in Scottish Index of Multiple Deprivation (SIMD) deciles 1–5 (more SE deprived); 70 practices in SIMD deciles 6–10 (less SE deprived).Patients 437 590 patients registered with a more SE deprived GP, and 333 994 patients registered with a less SE deprived GP, for the whole study period (2013–2016), who made at least one appointment.Outcomes The number of contacts and total contact time between patients and clinical staff.Results Patients in more SE deprived areas had slightly more discrete contacts over 3 years (11.8 vs 11.4), but each patient had marginally less contact time (146.1 vs 149.5 min). Stratified by sex and age, differences were also small. Stratified by the number of long-term conditions (LTCs), practices in more SE deprived areas delivered significantly less contact time than practices in less SE deprived areas. Over 3 years, 8 fewer minutes for patients with no LTCs, and 24, 27, 38 and 28 fewer minutes for patients with 1, 2, 3–4 or 5+LTCs, respectively.Conclusion If GPs in more SE deprived areas were to give an equal amount of direct contact time to patients with the same level of need served by GPs in less SE deprived areas, this would require a 14% increase in patient contact time. This represents a significant unmet need, supporting the case for redistribution of resources to tackle the inverse care law. |
| first_indexed | 2024-03-11T20:24:44Z |
| format | Article |
| id | doaj.art-e2321d35ff34494fa4b08d4867a0e2f4 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-24T14:02:43Z |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-e2321d35ff34494fa4b08d4867a0e2f42024-04-03T12:25:09ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2022-068720Quantifying unmet need in General Practice: a retrospective cohort study of administrative dataAlex McConnachie0Philip Wilson1Ross McQueenie2David A Ellis3Andrea E Williamson4Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UKCentre for Rural Health, University of Aberdeen, Aberdeen, UKPlace and Wellbeing Directorate, Public Health Scotland, Edinburgh, UKSchool of Management, University of Bath, Bath, UKGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UKObjectives To assess whether patients attending general practices (GPs) in socioeconomically (SE) deprived areas receive the same amount of care, compared with similar patients (based on age, sex and level of morbidity) attending GPs in less deprived areas. If not, to quantify the additional resource that would be required by GPs in deprived areas to achieve parity.Design Retrospective cohort study.Setting 150 GPs in Scotland, UK, divided into two groups: 80 practices in Scottish Index of Multiple Deprivation (SIMD) deciles 1–5 (more SE deprived); 70 practices in SIMD deciles 6–10 (less SE deprived).Patients 437 590 patients registered with a more SE deprived GP, and 333 994 patients registered with a less SE deprived GP, for the whole study period (2013–2016), who made at least one appointment.Outcomes The number of contacts and total contact time between patients and clinical staff.Results Patients in more SE deprived areas had slightly more discrete contacts over 3 years (11.8 vs 11.4), but each patient had marginally less contact time (146.1 vs 149.5 min). Stratified by sex and age, differences were also small. Stratified by the number of long-term conditions (LTCs), practices in more SE deprived areas delivered significantly less contact time than practices in less SE deprived areas. Over 3 years, 8 fewer minutes for patients with no LTCs, and 24, 27, 38 and 28 fewer minutes for patients with 1, 2, 3–4 or 5+LTCs, respectively.Conclusion If GPs in more SE deprived areas were to give an equal amount of direct contact time to patients with the same level of need served by GPs in less SE deprived areas, this would require a 14% increase in patient contact time. This represents a significant unmet need, supporting the case for redistribution of resources to tackle the inverse care law.https://bmjopen.bmj.com/content/13/9/e068720.full |
| spellingShingle | Alex McConnachie Philip Wilson Ross McQueenie David A Ellis Andrea E Williamson Quantifying unmet need in General Practice: a retrospective cohort study of administrative data BMJ Open |
| title | Quantifying unmet need in General Practice: a retrospective cohort study of administrative data |
| title_full | Quantifying unmet need in General Practice: a retrospective cohort study of administrative data |
| title_fullStr | Quantifying unmet need in General Practice: a retrospective cohort study of administrative data |
| title_full_unstemmed | Quantifying unmet need in General Practice: a retrospective cohort study of administrative data |
| title_short | Quantifying unmet need in General Practice: a retrospective cohort study of administrative data |
| title_sort | quantifying unmet need in general practice a retrospective cohort study of administrative data |
| url | https://bmjopen.bmj.com/content/13/9/e068720.full |
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