SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Does practice size matter? Review of effects on quality of care in primary care.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Primary care micro-teams: an international systematic review of patient and healthcare professional perspectives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Pooled it
- The impact of organisational factors on treatment outcomes for those seeking alcohol or other drug treatment: A systematic review.Drug and alcohol review · 2023Pooled it
- The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis.Journal of general internal medicine · 2020Pooled it
- The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Effects of collaborative care on recognition and management of common mental disorders by general practitioners: a cluster-randomised trial in Norway.BMC primary care · 2026Trial
- Trial
- Primary care preparedness to care for patients with ADRD: A national survey study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- General practice characteristics associated with pay-for-performance in the UK: a systematic review.BJGP open · 2025Article
- Article
- A comprehensive assessment of care competence and maternal experience of first antenatal care visits in Mexico: Insights from the baseline survey of an observational cohort study.PLoS medicine · 2024Observational
- Practice list size, workforce composition and performance in English general practice: a latent profile analysis.BMC primary care · 2024Article
- Additional roles reimbursement to primary care networks: an uplift or downfall of general practice partnership?The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The safety of patient management in family medicine in Slovenia during Covid-19: a cross-sectional study.BMC primary care · 2023Article
- Is there equity of patient health outcomes across models of general practice in Aotearoa New Zealand? A national cross-sectional study.International journal for equity in health · 2023Article
- Considerations for Patient Panel Size.Delaware journal of public health · 2022Article
- Practice Billing for Medicare Advance Care Planning Across the USA.Journal of general internal medicine · 2022Article
- Article
- Organization of primary care.Primary health care research & development · 2022Review
- Article
- Orthopaedic Group Practice Size Is Increasing.Arthroscopy, sports medicine, and rehabilitation · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a trend towards consolidating smaller primary care practices into larger practices worldwide. However, the effects of practice size on quality of care remain unclear.
aimThis review aims to systematically appraise the effects of practice size on the quality of care in primary care. DESIGN AND
settingA systematic review and narrative synthesis of studies examining the relationship between practice size and quality of care in primary care.
methodQuantitative studies that focused on primary care practices or practitioners were identified through PubMed, CINAHL, Embase, Cochrane Library, CRD databases, ProQuest dissertations and theses, conference proceedings, and MedNar databases, as well as the reference lists of included studies. Independent variables were team or list size; outcome variables were measures of clinical processes, clinical outcomes, or patient-reported outcomes. A narrative synthesis of the results was conducted.
resultsThe database search yielded 371 articles, of which 34 underwent quality assessment, and 17 articles (13 cross-sectional studies) were included. Ten studies examined the association of practice size and clinical processes, but only five found associations of larger practices with selected process measures such as higher specialist referral rates, better adherence to guidelines, higher mammography rates, and better monitoring of haemoglobin A1c. There were mixed results for cytology and pneumococcal coverage. Only one of two studies on clinical outcomes found an effect of larger practices on lower random haemoglobin A1 value. Of the three studies on patient-reported outcomes, smaller practices were consistently found to be associated with satisfaction with access, but evidence was inconsistent for other patient-reported outcomes evaluated.
conclusionThere is limited evidence to support an association between practice size and quality of care in primary care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.