Evidence map›Paper›PMID 39920057›Full record

Observational studyBMJ open2025

Heterogeneous association of health with patient and general practice characteristics by region, age and chronic condition: pooled cross-sectional study of patient-level data from England.

Yan Feng, Hugh Gravelle, Vladimir Sergeevich Gordeev

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Yan FengCentre for Evaluation and Methods, Queen Mary University of London, London, UK yan.feng@qmul.ac.uk.ORCID http://orcid.org/0000-0003-4436-1126
Hugh GravelleCentre for Health Economics, University of York, York, UK.
Vladimir Sergeevich GordeevCentre for Evaluation and Methods, Queen Mary University of London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the association of individual patient health with their characteristics, including income deprivation, ethnicity and gender, with the size, quality and staffing of their general practices, and how these associations and income-related health inequality vary across chronic conditions, regions and age bands.

designUsing observational pooled cross-sectional individual patient survey data linked with data on general practice clinical quality and staffing and deprivation at Lower-Layer Super Output Area level. Ordinary least-squares multiple regression models of patient health estimated on the full sample and on eight condition-specific, nine region-specific and six age-specific subsamples. Three concentration indices embodying different value judgements summarise income-related health inequality in the full sample and subsamples.

settingPrimary care in England.

participantsOver 1 million adult patients in 6426 general practices in 2015/2016 and 2016/2017. PRIMARY OUTCOME MEASURES: Patient-reported health (the 5-level EQ-5D version or EQ-5D-5L).

resultsPatients who are younger, male, more satisfied with their practice, have fewer chronic conditions and live in less-income or education-deprived areas report better health. White ethnicity is associated with worse health up to age 64 and better health from age 65, with better health in five of the eight chronic condition samples, and in the regional samples except for London and Yorkshire and Humber regions. Practice clinical quality is positively associated with health in the full sample but only in 4 of the 23 subsamples. Income-related health inequality is worst for patients with a mental health problem, residents in the northwest and northeast regions and is greatest for those aged 55-64. The three concentration indices are highly positively correlated across chronic condition and age-band samples. One index has a much weaker correlation relationship with the other two indices in the region-specific samples.

conclusionIncome-related health inequality and the associations of health with patient and practice characteristics are heterogeneous by patients' chronic condition, age and region.

Indexed as

General PracticeHealth Status DisparitiesAdolescentAdultAgedAge FactorsChronic DiseaseCross-Sectional StudiesEnglandFemaleHumansIncomeMaleMiddle AgedSex FactorsSocioeconomic FactorsChronic DiseaseCross-Sectional StudiesHealth EquityPatient Reported Outcome MeasuresPrimary Healthcare

Identifiers

PMID39920057
PMCPMC11815445

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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.