ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2015
General practice funding underpins the persistence of the inverse care law: cross-sectional study in Scotland.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- The impact of primary care funding on health inequalities: an umbrella review.Primary health care research & development · 2025Pooled it
- Recruitment and characteristics of participants in trials of physical activity for adults aged 45 years and above in general practice: a systematic review.Family practice · 2023Pooled it
- Pooled it
- Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis.PloS one · 2018Pooled it
- Resources in vulnerable young adults: self-assessments during preventive consultation with their general practitioner in Denmark.Health promotion international · 2020Trial
- Effectiveness of Community-Links Practitioners in Areas of High Socioeconomic Deprivation.Annals of family medicine · 2019Trial
- "There is never any rest, never enough time and too much to do": a qualitative study of GP work intensity in an Irish context.BMC primary care · 2026Article
- Article
- Deep End Placements and Social Empathy: Single Centered Before-After Study in Japan.Advances in medical education and practice · 2026Article
- Article
- Has the new GP contract in Scotland reduced health inequalities? Qualitative evaluation of the views of general practitioners working in deprived areas.International journal for equity in health · 2025Article
- Addressing the inverse care law in Scottish general practice: systematic scoping review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Adjusting primary-care funding by deprivation: a cross-sectional study of Lower layer Super Output Areas in England.BJGP open · 2025Article
- Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis.BJGP open · 2025Article
- 'Challenging but ultimately rewarding' - lived experiences of Deep End Northern Ireland GPs: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Evaluating a new obesity indicator for stroke risk prediction: comparative cohort analysis in rural settings of two nations.BMC public health · 2024Article
- Article
- Storylines of family medicine X: standing up for diversity, equity and inclusion.Family medicine and community health · 2024Article
- Health inequalities, multimorbidity and primary care in Scotland.Future healthcare journal · 2023Article
- Is Scotland's new GP contract addressing the inverse care law?Future healthcare journal · 2023Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundUniversal access to health care, as provided in the NHS, does not ensure that patients' needs are met.
aimTo explore the relationships between multimorbidity, general practice funding, and workload by deprivation in a national healthcare system. DESIGN AND
settingCross-sectional study using routine data from 956 general practices in Scotland.
methodEstimated numbers of patients with multimorbidity, estimated numbers of consultations per 1000 patients, and payments to practices per patient are presented and analysed by deprivation decile at practice level.
resultsLevels of multimorbidity rose with practice deprivation. Practices in the most deprived decile had 38% more patients with multimorbidity compared with the least deprived (222.8 per 1000 patients versus 161.1; P<0.001) and over 120% more patients with combined mental-physical multimorbidity (113.0 per 1000 patients versus 51.5; P<0.001). Practices in the most deprived decile had 20% more consultations per annum compared with the least deprived (4616 versus 3846, P<0.001). There was no association between total practice funding and deprivation (Spearman ρ -0.09; P = 0.03). Although consultation rates increased with deprivation, the social gradients in multimorbidity were much steeper. There was no association between consultation rates and levels of funding.
conclusionNo evidence was found that general practice funding matches clinical need, as estimated by different definitions of multimorbidity. Consultation rates provide only a partial estimate of the work involved in addressing clinical needs and are poorly related to the prevalence of multimorbidity. In these circumstances, general practice is unlikely to mitigate health inequalities and may increase them.
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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.