McConnachie, A. , Ellis, D. E., Wilson, P., McQueenie, R. and Williamson, A. E. (2023) Quantifying unmet need in General Practice: a retrospective cohort study of administrative data. BMJ Open, 13(9), e068720. (doi: 10.1136/bmjopen-2022-068720) (PMID:37714681)
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Abstract
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.
| Item Type: | Articles |
|---|---|
| Additional Information: | Funding This work was supported by a grant from Chief Scientist Office, Scottish Government (reference CZH/4/1118) with Safe Haven and data linkage costs supported in lieu by the DSLS at Scottish Government. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McConnachie, Professor Alex and Williamson, Professor Andrea |
| Authors: | McConnachie, A., Ellis, D. E., Wilson, P., McQueenie, R., and Williamson, A. E. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | BMJ Open |
| Publisher: | BMJ Publishing Group |
| ISSN: | 2044-6055 |
| ISSN (Online): | 2044-6055 |
| Published Online: | 15 September 2023 |
| Copyright Holders: | Copyright © Author(s) (or their employer(s)) 2023 |
| First Published: | First published in BMJ Open 13(9):e068720 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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