| Characteristics of general practices associated with emergency-department attendance rates: a cross-sectional study. | |
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MedLine Citation:
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PMID: 21685185 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background Strategies are needed to contain emergency-department attendance. Quality of care in general practice might influence the use of emergency departments, including management of patients with chronic conditions and access to consultations. Aim The aim was to determine whether emergency-department attendance rates are lower for practices with higher quality and outcomes framework performance and lower for practices with better patient reported access. Design A cross-sectional study. Setting Two English primary-care trusts, Leicester City and Leicestershire County and Rutland, with 145 general practices. Method Using data on attendances at emergency departments in 2006/2007 and 2007/2008, a practice attendance rate was calculated for each practice. In a hierarchical negative binomial regression model, practice population characteristics (deprivation, proportion of patients aged 65 or over, ethnicity, gender) and practice characteristics (total list size, distance from the emergency department, quality and outcomes framework points, and variables measuring satisfaction with access) were included as potential explanatory variables. Results In both years, greater deprivation, shorter distance from the central emergency department, lower practice list size, white ethnicity and lower satisfaction with practice telephone access were associated with higher emergency-department attendance rates. Conclusions Performance as indicated by the quality and outcomes framework did not predict rates of attendance at emergency departments, but satisfaction with telephone access did. Consideration should be given to improving access to some general practices to contain the use of emergency departments. |
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Authors:
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R Baker; M J Bankart; A Rashid; J Banerjee; S Conroy; M Habiba; R Hsu; A Wilson; S Agarwal; J Camosso-Stefinovic |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-16 |
Journal Detail:
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Title: BMJ quality & safety Volume: - ISSN: 2044-5423 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101546984 Medline TA: BMJ Qual Saf Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Health Sciences, NIHR CLAHRC for LNR, University of Leicester, Leicester, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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