ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2017
Opportunities for primary care to reduce hospital admissions: a cross-sectional study of geographical variation.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of relational continuity of primary care in aged care: a systematic review.BMC geriatrics · 2022Pooled it
- GP- and practice-related variation in ambulatory sensitive hospitalisations of older primary care patients.BMC family practice · 2020Trial
- Article
- The relationship between general practice characteristics, case-mix, and secondary care attendances/admissions before and after the COVID-19 pandemic: Protocol for an OpenSAFELY cohort study.Wellcome open research · 2025Article
- Hospital care direct costs due to ambulatory care sensitive conditions related to diabetes mellitus in the Mexican public healthcare system.BMC health services research · 2024Article
- Association between spatial access and hospitalization for ambulatory care sensitive conditions: A retrospective cohort study using claims data.SSM - population health · 2024Article
- Article
- Predicting Future Geographic Hotspots of Potentially Preventable Hospitalisations Using All Subset Model Selection and Repeated K-Fold Cross-Validation.International journal of environmental research and public health · 2021Article
- Associations of GP practice characteristics with the rate of ambulatory care sensitive conditions in people living with dementia in England: an ecological analysis of routine data.BMC health services research · 2021Article
- Direct Medical Costs of Spinal Muscular Atrophy in the Catalonia Region: A Population-Based Analysis.Clinical drug investigation · 2020Article
- Article
- A proactive general practice: Integrating public health into primary care.London journal of primary care · 2018Article
- How do population, general practice and hospital factors influence ambulatory care sensitive admissions: a cross sectional study.BMC family practice · 2017Article
- General practice and the Sustainability and Transformation imperatives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults.Journal of multimorbidity and comorbidityArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible.
aimTo identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND
settingCross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012.
methodThe authors used random effects Poisson models to estimate interpractice variation after adjusting for several drivers of healthcare need and availability of local hospital services. Interpractice variation was contrasted across patient subgroups based on age.
resultsThere were 1.8 million hospital admissions. Overall, high-utilisation practices had ACSC admission rates that were 55% (95% CI = 53 to 56) greater than low-utilisation practices. Differences of 67% (95% CI = 65 to 69) were found for chronic ACSCs, which was much larger than the 51% (95% CI = 49 to 52) difference exhibited by acute presentations. At least two-fold differences were found for 15 (54%) ACSCs, although large interpractice variations were not ubiquitous. Admission rates were consistently more variable among younger-than-average patients. The most variable conditions tended to disproportionately affect deprived patients.
conclusionSubstantial interpractice variation suggests that current efforts to standardise primary care have had a limited effect on unplanned hospital admissions. GPs and healthcare commissioners should ensure they are offering best practice care for the most variable clinical areas and patient subgroups identified in the study, particularly in adults aged <70 years with chronic conditions.
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