Document Detail


Hospital data may be more accurate than census data in estimating the ethnic composition of general practice populations.
MedLine Citation:
PMID:  19807948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Equity of service provision by age, ethnicity and sex is a key aim of Government policy in the UK. The prevalence, natural history and management of common chronic conditions, such as diabetes and hypertension, vary between ethnic groups. Developing and monitoring responsive local services requires accurate measures of ethnicity and language needs. Hence establishing the ethnic composition of GP populations is important. OBJECTIVE: To compare three methods of estimating the ethnic composition of GP registered populations in three east London primary care trusts (PCTs). DESIGN: Self-reported ethnicity, routinely collected at practice level (and considered the 'gold standard'), was compared with two indirect methods of attributing ethnicity. The indirect method currently used in the UK assigns ethnicity to GP populations based on geographical postcode attribution from the national census. A proposed alternative indirect method uses the ethnic breakdown of hospital admission data from practice lists to attribute ethnicity to the whole practice population. Comparisons were made between practice self-report recording and these two indirect methods. Bland-Altman plots were used to assess the agreement between methods of measurement. RESULTS: Data from 103 practices, covering 70% of the GP registered population, was used. The hospital admission method showed better agreement with practice self-report data than the census attributed method. For white populations Bland-Altman plots showed a mean difference of 1.4% (95% CI-14.9 to 17.7) between hospital admission and practice data, and a mean difference of 12.5% (95% CI-6.2 to 31.1) between census attributed and practice data. Differences were also found for south Asian and black populations. CONCLUSION: Practice ethnicity measured using hospital attendance data is in closer agreement with practice recording of self-reported ethnicity than the census attribution method. Census attribution may provide misleading information on the ethnic composition of practice populations. We recommend that healthcare commissioners change to this method of measurement when practice self-report data is not available.
Authors:
Sally A Hull; Carol Rivas; Jacqui Bobby; Kambiz Boomla; John Robson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Informatics in primary care     Volume:  17     ISSN:  1476-0320     ISO Abbreviation:  Inform Prim Care     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-07     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101150138     Medline TA:  Inform Prim Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-78     Citation Subset:  IM    
Affiliation:
Centre for Health Sciences, Barts and the London Queen Mary's School of Medicine, London, UK. s.a.hall@qmul.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Catchment Area (Health) / statistics & numerical data
Censuses*
Ethnic Groups / statistics & numerical data*
Health Policy
Health Services Accessibility / standards,  statistics & numerical data*
Hospital Records / statistics & numerical data*
Humans
London
Primary Health Care / standards,  statistics & numerical data*
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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