Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.

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Lateral back pain identifies prevalent vertebral fractures in post-menopausal women: cross-sectional analysis of a primary care-based cohort. Clark EM, Hutchinson AP, McCloskey EV, et al. Rheumatology (Oxford) 2010;49(3):505–12. Epub 2009 Dec 16

The Spine Journal ◽

10.1016/j.spinee.2010.06.029 ◽

2010 ◽

Vol 10 (9) ◽

pp. 842

Keyword(s):

Primary Care ◽

Back Pain ◽

Vertebral Fractures ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Menopausal Women ◽

Post Menopausal ◽

Sectional Analysis

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Acne in primary care: A cross-sectional analysis

10.31128/ajgp-02-19-4864 ◽

2019 ◽

Vol 48 (11) ◽

pp. 781-788

Author(s):

Hilary Brown ◽

Amanda Tapley ◽

Mieke L van Driel ◽

Andrew R Davey ◽

Elizabeth Holliday ◽

...

Keyword(s):

Primary Care ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Deprivation and primary care funding in Greater Manchester after devolution: a cross-sectional analysis

British Journal of General Practice ◽

10.3399/bjgp19x705545 ◽

2019 ◽

Vol 69 (688) ◽

pp. e794-e800

Author(s):

Jessica A Lee ◽

Rachel Meacock ◽

Evangelos Kontopantelis ◽

James Matheson ◽

Matthew Gittins

Keyword(s):

Primary Care ◽

Health Inequities ◽

Care Quality ◽

Area Deprivation ◽

Cross Sectional ◽

Practice Location ◽

Cross Sectional Analysis ◽

Health And Social Care ◽

Sectional Analysis ◽

Quality Measurements

BackgroundIn April 2016 Greater Manchester gained control of its health and social care budget, a devolution that aimed to reduce health inequities both within Greater Manchester and between Greater Manchester and the rest of the country.AimTo describe the relationship between practice location deprivation and primary care funding and care quality measurements in the first year of Greater Manchester devolution (2016/2017).Design and settingCross-sectional analysis of 472 general practices in Greater Manchester in England.MethodFinancial data for each general practice were linked to the area deprivation of the practice location, as measured by the 2015 Index of Multiple Deprivation. Practices were categorised into five quintiles relative to national deprivation. NHS Payments data and indicators of care quality were compared across social deprivation quintiles.ResultsPractices in areas of greater deprivation did not receive additional funding per registered patient. Practices in less deprived quintiles received higher National Enhanced Services payments from NHS England than practices in the most deprived quintile. A trend was observed towards funding to more deprived practices being supported by Local Enhanced Service payments from clinical commissioning groups, but these represent a small proportion of overall practice income. Practices in less deprived areas had better care quality measurements according to Quality and Outcomes Framework achievement and Care Quality Commission ratings.ConclusionFollowing devolution, primary care practices in Greater Manchester are still reliant on funding from national funding schemes, which poorly reflect its deprivation. The devolved administration’s ability to address health inequities at the primary care level seems uncertain.

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