R Carlisle1, S Johnstone. 1. Department of General Practice, University of Nottingham, University Hospital Nottingham. roundwood@innotts.co.uk
Abstract
BACKGROUND: The relationship between socio-economic factors and consultation rates is important in determining resource allocation to general practices. AIM: To determine the relationship between general practice surgery consultation rates and census-derived socio-economic variables for patients receiving the same primary and secondary care. METHOD: A retrospective analysis was taken of computerized records in three general practices in Mansfield, North Nottinghamshire, with 29,142 patients spread over 15 electoral wards (Jarman score range from -23 to +25.5). Linear regression analysis of surgery consultation rates at ward and enumeration district levels was performed against Jarman and Townsend deprivation scores and census socio-economic variables. RESULTS: Both the Townsend score (r2 = 59%) and the Jarman score (r2 = 39%) were associated with surgery consultation rates at ward level. The Townsend score had a stronger association than the Jarman score because all four of its component variables were individually associated with increased consultations compared with four out of eight Jarman components. CONCLUSIONS: Even in practices not eligible for deprivation payments there were appreciable differences in consultation rates between areas with different socio-economic characteristics. The results suggest that the variables used to determine deprivation payments should be reconsidered, and they support suggestions that payments should be introduced at a lower level of deprivation and administered on an enumeration district basis.
BACKGROUND: The relationship between socio-economic factors and consultation rates is important in determining resource allocation to general practices. AIM: To determine the relationship between general practice surgery consultation rates and census-derived socio-economic variables for patients receiving the same primary and secondary care. METHOD: A retrospective analysis was taken of computerized records in three general practices in Mansfield, North Nottinghamshire, with 29,142 patients spread over 15 electoral wards (Jarman score range from -23 to +25.5). Linear regression analysis of surgery consultation rates at ward and enumeration district levels was performed against Jarman and Townsend deprivation scores and census socio-economic variables. RESULTS: Both the Townsend score (r2 = 59%) and the Jarman score (r2 = 39%) were associated with surgery consultation rates at ward level. The Townsend score had a stronger association than the Jarman score because all four of its component variables were individually associated with increased consultations compared with four out of eight Jarman components. CONCLUSIONS: Even in practices not eligible for deprivation payments there were appreciable differences in consultation rates between areas with different socio-economic characteristics. The results suggest that the variables used to determine deprivation payments should be reconsidered, and they support suggestions that payments should be introduced at a lower level of deprivation and administered on an enumeration district basis.
Authors: Esther T Kok; Arthur M Bohnen; J L H Ruud Bosch; Siep Thomas; Frans P M J Groeneveld Journal: Qual Life Res Date: 2006-07-07 Impact factor: 4.147
Authors: Mary Dixon-Woods; Debbie Cavers; Shona Agarwal; Ellen Annandale; Antony Arthur; Janet Harvey; Ron Hsu; Savita Katbamna; Richard Olsen; Lucy Smith; Richard Riley; Alex J Sutton Journal: BMC Med Res Methodol Date: 2006-07-26 Impact factor: 4.615