| Did the London Initiative Zone investment programme affect general practice structure and performance in East London? A time series analysis of cervical screening coverage and asthma prescribing. | |
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MedLine Citation:
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PMID: 12407476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A programme of incentives was set up in the London Initiative Zones to improve primary care in inner London based on the findings of the Tomlinson Enquiry in 1992. This descriptive study is a 4-y time series analysis of changes in general practice structure in East London as the result of London Initiative Zone investment, and an exploration of the possible effect of investment on practice performance. We used routinely available administrative data for the whole analysis. General practice characteristics and two selected performance indicators: the asthma prophylaxis to bronchodilator ratio and cervical cytology screening rate, for all practices in the East London and the City Health Authority for 4 y, 1993-1996, were used. Both reflect practice efficiency, but relate to different aspects of practice performance. The prescribing indicator is more indicative of the quality of clinical practise, whereas cervical screening coverage relates more to the characteristics of the practice population and to practice organisation. Repeated measures analyses were used to identify trends and to explore the relationship between changes in practice characteristics and performance. Graphical methods were used to compare East London trends with the rest of England. There were significant improvements in practice structure as the consequence of London Initiative Zone investment. There was a positive association with improvements in practice performance, but East London still lagged some way behind national patterns. The findings suggest that while improvements in asthma prescribing follow the national trend, practices have difficulty in achieving and sustaining the 80% target for cervical cytology screening, and that an overall population coverage of 80% may be in doubt.Increased investment in practice staffing may be influential in improving some aspects of performance. However, in common with other inner cities, a greater effort and more innovative strategies may be needed to achieve a standard of performance equal to the best. |
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Authors:
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J Naish; S Eldridge; K Moser; P Sturdy |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Public health Volume: 116 ISSN: 0033-3506 ISO Abbreviation: Public Health Publication Date: 2002 Nov |
Date Detail:
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Created Date: 2002-10-30 Completed Date: 2003-02-20 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 0376507 Medline TA: Public Health Country: England |
Other Details:
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Languages: eng Pagination: 361-7 Citation Subset: IM |
Affiliation:
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The City and East London General Practice Database Project, Department of General Practice & Primary Care, University of London, UK. j.c.naish@qmul.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Asthmatic Agents
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therapeutic use* Asthma / drug therapy*, epidemiology Bronchodilator Agents / therapeutic use* Family Practice / organization & administration, standards* Female Health Care Surveys Humans Investments London Male Mass Screening / utilization* Primary Health Care / organization & administration, standards* Program Evaluation Quality Indicators, Health Care* State Medicine / standards Total Quality Management / economics Urban Health Services / organization & administration, standards* Uterine Cervical Neoplasms / diagnosis*, epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Asthmatic Agents; 0/Bronchodilator Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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