ArticleThe European journal of general practice2025
Variation in the efficiency of English general practices and associated factors: A cross-sectional study of 5069 general practices.
Article in The European journal of general practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundHealthcare demand in English general practice exceeds supply, necessitating practice efficiency. To our knowledge, no study has explored factors associated with practice efficiency in England using a quality-adjusted output.
objectivesTo determine practice-level efficiency in England and identify associated factors using a quality-adjusted output.
methodsWe conducted a cross-sectional study using NHS datasets from 2023. Practice efficiency was determined by comparing input (measured using funding and workforce) with output (measured using clinical quality, patient experience, and service volume). Practices were classified as efficient (low input, high output), neutral (same input and output levels), or inefficient (high input, low output) using K-medoids clustering, a machine learning technique. Multivariable logistic regression was used to identify factors associated with practice efficiency (i.e. efficient or inefficient, excluding neutral).
resultsOf 5069 practices, 1117 were classified as efficient, 2773 as neutral, and 1179 as inefficient. Efficiency was lower in practices with a larger patient list (adjusted odds ratio 0.23, 95% CI 0.19-0.28), those with a higher percentage of patients with a chronic condition (0.47, 0.38-0.58) or patients ≥ 65 years (0.63, 0.49-0.81), those in a higher deprivation area (0.25, 0.20-0.32), those that dispense medications (0.52, 0.37-0.73), and those with an alternative provider medical services (vs. general medical services) contract (0.15, 0.07-0.33). Efficiency was higher in urban practices (1.38, 1.00-1.90) and practices with a higher percentage of mixed (1.66, 1.24-2.21) or other ethnicity patients (1.78, 1.22-2.60).
conclusionSmaller practices were more efficient. Therefore, policies that encourage practice mergers may not deliver the efficiency gains expected.
Indexed as
Identifiers
What OpenQuestion holds
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.