Does shortage of GPs matter? A cross-sectional study of practice population life expectancy.
Br J Gen Pract
; 74(742): e283-e289, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38621806
ABSTRACT
BACKGROUND:
There are not enough GPs in England. Access to general practice and continuity of care are declining.AIM:
To investigate whether practice characteristics are associated with life expectancy of practice populations. DESIGN ANDSETTING:
A cross-sectional ecological study of patient life expectancy from 2015-2019.METHOD:
Selection of independent variables was based on conceptual frameworks describing general practice's influence on outcomes. Sixteen non-correlated variables were entered into multivariable weighted regression models population characteristics (Index of Multiple Deprivation, region, % White ethnicity, and % on diabetes register); practice organisation (total NHS payments to practices expressed as payment per registered patient, full-time equivalent fully qualified GPs, GP registrars, advanced nurse practitioners, other nurses, and receptionists per 1000 patients); access (% seen on the same day); clinical performance (% aged ≥45 years with blood pressure checked, % with chronic obstructive pulmonary disease vaccinated against flu, % with diabetes in glycaemic control, and % with coronary heart disease on antiplatelet therapy); and the therapeutic relationship (% continuity).RESULTS:
Deprivation was strongly negatively associated with life expectancy. Regions outside London and White ethnicity were associated with lower life expectancy. Higher payment per patient, full-time equivalent fully qualified GPs per 1000 patients, continuity, % with chronic obstructive pulmonary disease having the flu vaccination, and % with diabetes with glycaemic control were associated with higher life expectancy; the % being seen on the same day was associated with higher life expectancy in males only. The variable aged ≥45 years with blood pressure checked was a negative predictor in females.CONCLUSION:
The number of GPs, continuity of care, and access in England are declining, and it is worrying that these features of general practice were positively associated with life expectancy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Expectativa de Vida
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Medicina Geral
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Clínicos Gerais
Limite:
Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article