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Are more GPs associated with a reduction in emergency hospital admissions? A quantitative study on GP referral in England

Abstract:
Background Recent studies have found an association between access to primary care and accident and emergency attendances, with better access associated with fewer attendances. Analyses of an association with emergency admissions, however, have produced conflicting findings.
Aim This study investigated whether emergency admission rates in an area are associated with 1) the number of GPs, and 2) mean size of GP practice.
Design and setting Analysis was conducted utilising Hospital Episode Statistics, the numbers of GPs and GP practices, Office for National Statistics population data, Quality and Outcomes Framework prevalence data, and Index of Multiple Deprivation data, from 2004/2005 to 2011/2012, for all practices in England.
Method Regression analysis of panel data with fixed effects to address 1) a potential two-way relationship between the numbers of GPs and emergency admissions, and 2) unobservable characteristics of GP practices.
Results There is not a statistically significant relationship between the number of GPs in a primary care trust area and the number of emergency admissions, when analysing all areas. In deprived areas, however, a higher number of GPs is associated with lower emergency admissions. There is also a lower emergency admission rate in areas in which practices are on average larger, holding GP supply constant.
Conclusion An increase in GPs was found to reduce emergency admissions in deprived areas, but not elsewhere. Areas in which GPs are concentrated into larger practices showed reduced levels of emergency admissions, all else being equal.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3399/bjgp.2020.0737

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Sub department:
Primary Care Health Sciences
Oxford college:
Nuffield College
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Sub department:
Primary Care Health Sciences
Oxford college:
Harris Manchester College
Role:
Author
ORCID:
0000-0001-7976-7172


Publisher:
Royal College of General Practitioners
Journal:
British Journal of General Practice More from this journal
Volume:
71
Issue:
705
Pages:
e287-e295
Publication date:
2021-03-26
Acceptance date:
2020-10-27
DOI:
EISSN:
1478-5242
ISSN:
0960-1643
Pmid:
33685922


Language:
English
Keywords:
Pubs id:
1167711
Local pid:
pubs:1167711
Deposit date:
2021-04-22

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