Evidence map›Paper›PMID 30564699›Full record

ArticleBJGP open2018

Capturing complexity in clinician case-mix: classification system development using GP and physician associate data.

Mary Halter, Louise Joly, Simon de Lusignan, Robert L Grant, Heather Gage, Vari M Drennan

Open access · goldAbstract read
In one paragraph

Article in BJGP open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 16% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Mary HalterAssociate Professor, Faculty of Health, Social Care & Education, Kingston University & St George's, University of London, London, UK.
Louise JolyResearch Fellow, Social Care Workforce Unit, King's College London, London, UK.
Simon de LusignanProfessor of Primary Care and Clinical Informatics, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK.
Robert L GrantHonorary Research Fellow, Faculty of Health, Social Care & Education, Kingston University & St George's, University of London, London, UK.
Heather GageProfessor of Health Economics, School of Economics, University of Surrey, Guildford, UK.
Vari M DrennanProfessor of Health Care and Policy Research, Faculty of Health, Social Care & Education, Kingston University & St George's, University of London, London, UK.
St George's, University of London · GBInstitute of Health Economics · CAKing's College London · GBUniversity of Surrey · GB

Funding

Department of Health 09/1801/1066
6 · The paper itself

Abstract

backgroundThere are limited case-mix classification systems for primary care settings which are applicable when considering the optimal clinical skill mix to provide services.

aimTo develop a case-mix classification system (CMCS) and test its impact on analyses of patient outcomes by clinician type, using example data from physician associates' (PAs) and GPs' consultations with same-day appointment patients. DESIGN &

settingSecondary analysis of controlled observational data from six general practices employing PAs and six matched practices not employing PAs in England.

methodRoutinely-collected patient consultation records (PA

resultsA CMCS was developed by extending a system that only classified 18.6% (213/1147) of the presenting problems in this study's data. The CMCS differentiated the presenting patient's level of need or complexity as: acute, chronic, minor problem or symptom, prevention, or process of care, applied hierarchically. Combination of patient and consultation-level measures resulted in a higher classification of acuity and complexity for 639 (30.6%) of patient cases in this sample than if using consultation level alone. The CMCS was a key adjustment in modelling the study's main outcome measure, that is rate of repeat consultation.

conclusionThis CMCS assisted in classifying the differences in case-mix between professions, thereby allowing fairer assessment of the potential for role substitution and task shifting in primary care, but it requires further validation.

Indexed as

case-mixclassificationgeneral practicemethodsphysician assistantsphysician associate

Identifiers

PMID30564699
PMCPMC6181080
OpenAlexW2763306768

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.