May 17, 2011
Patients Who See Preferred Doctor Less Likely To Go For Emergency Hospital Admission
New study draws link between patient choice and hospital admissions
A new study led by the University of Leicester has concluded that being able to see the GP of your choice in a doctor's surgery helps to reduce emergency hospital admissions.
The research, published in Emergency Medical Journal, was led by Dr John Bankart, a research fellow in medical statistics at the University. The research was funded by the NHS.
Dr Bankart said: "We undertook a study to identify characteristics of general practices associated with emergency hospital admission rates. The study was undertaken in two primary care trusts (Leicester City and Leicestershire County and Rutland) and included 145 general practices.
"Hospital admission data were used to calculate the rate of emergency admissions for two consecutive years (2006/07 and 2007/08), and we studied the impact of practice characteristics and patient characteristics on admission rates.
"We found that practice characteristics - like being a shorter distance from hospital and smaller list sizes and patient characteristics such as a higher proportion of older people, white ethnicity, increasing deprivation, and female gender were associated with higher admission rates. There was no association with measures of clinical or organisational performance, but there was an association between patients reporting being able to see a particular GP and admission rates.
"As the proportion of patients able to consult a particular GP increased, emergency admission rates declined. We concluded that the patient characteristics of deprivation, age, ethnicity and gender are important predictors of admission rates. Larger practices and greater distance from a hospital have lower admission rates. Being able to consult a particular GP, an aspect of continuity, is associated with lower emergency admission rates. "
Dr Bankart said the results demonstrated the fact that GP practices will struggle to impact on hospital admission rates given that many of the factors that influence hospital admissions were outside the GP's control eg higher proportion of elderly, white ethnicity, increasing deprivation and distance from hospital.
"This finding is important because small changes in admission rates have substantial economic consequences, and it points to potential interventions to reduce emergency admission rates."
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