ArticleBMJ open2016
Population characteristics, mechanisms of primary care and premature mortality in England: a cross-sectional study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Continuity of care with doctors-a matter of life and death? A systematic review of continuity of care and mortality.BMJ open · 2018Pooled it
- Pooled it
- Consultations with locum doctors in UK general practice: longitudinal analysis of electronic health records.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Strong Association of Perceived Chronic Stress with Leadership Quality, Work-Privacy Conflict and Quantitative Work Demands: Results of the IMPROVEBehavioral sciences (Basel, Switzerland) · 2025Article
- Change of primary health care service provider model in Vantaa: the impact on mortality and causes of death among older adults - a register-based follow-up study.BMC health services research · 2025Article
- Strengthening general practice will help improve longevity and could reduce health inequalities.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Does shortage of GPs matter? A cross-sectional study of practice population life expectancy.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Comparison of two GP service provider models in older adults: a register-based follow-up study.BJGP open · 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
- [Quality Indicators for Video Consultations in Primary Care - a Scoping Review].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023Article
- Is There a Better Way to Produce a Health Workforce for the Population?Family medicine · 2023Article
- Development and Validation of a County-Level Social Determinants of Health Risk Assessment Tool for Cardiovascular Disease.Annals of family medicine · 2020Article
- Maintaining a Sufficient Primary Care Workforce: A Problem We Should Not Have.Frontiers in medicine · 2020Article
- Associations Between Physician Supply Levels and Amenable Mortality Rates: An Analysis of Taiwan Over Nearly 4 Decades.Health services insights · 2020Article
- Cardiovascular mortality and risk behaviours by degree of urbanization before, during and after the economic crisis in Spain.BMC public health · 2019Article
- Article
- Impact of preventive primary care on children's unplanned hospital admissions: a population-based birth cohort study of UK children 2000-2013.BMC medicine · 2018Article
- Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014.International journal of environmental research and public health · 2018Article
- Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013-2014 and 2014-2015.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesHealth systems with strong primary care tend to have better population outcomes, but in many countries demand for care is growing. We sought to identify mechanisms of primary care that influence premature mortality.
designWe developed a conceptual model of the mechanisms by which primary care influences premature mortality, and undertook a cross-sectional study in which population and primary care variables reflecting the model were used to explain variations in mortality of those aged under 75 years. The premature standardised mortality ratios (SMRs) for each practice, available from the Department of Health, had been calculated from numbers of deaths in the 5 years from 2006 to 2010. A regression model was undertaken with explanatory variables for the year 2009/2010, and repeated to check stability using data for 2008/2009 and 2010/2011.
settingAll general practices in England were eligible for inclusion and, of the total of 8290, complete data were available for 7858.
resultsPopulation variables, particularly deprivation, were the most powerful predictors of premature mortality, but the mechanisms of primary care depicted in our model also affected mortality. The number of GPs/1000 population and detection of hypertension were negatively associated with mortality. In less deprived practices, continuity of care was also negatively associated with mortality.
conclusionsGreater supply of primary care is associated with lower premature mortality even in a health system that has strong primary care (England). Health systems need to sustain the capacity of primary care to deliver effective care, and should assist primary care providers in identifying and meeting the needs of socioeconomically deprived groups.
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