Does distance matter? Geographical variation in GP out-of-hours service use: an observational study
Does distance matter? Geographical variation in GP out-of-hours service use: an observational study
Background: GP cooperatives are typically based in emergency primary care centres, and patients are frequently required to travel to be seen. Geography is a key determinant of access, but little is known about the extent of geographical variation in the use of out-ofhours services.
Aim: To examine the effects of distance and rurality on rates of out-of-hours service use.
Design of study: Geographical analysis based on routinely collected data on telephone calls in June (n = 14 482) and December (n = 19 747), and area-level data.
Setting: Out-of-hours provider in Devon, England serving nearly one million patients.
Method: Straight-line distance measured patients’ proximity to the primary care centre. At area level, rurality was measured by Office for National Statistics Rural and Urban Classification (2004) for output areas, and deprivation by The Index of Multiple Deprivation (2004).
Results: Call rates decreased with increasing distance: 172 (95% confidence interval (CI) = 170 to 175) for the first (nearest) distance quintile, 162 (95% CI = 159 to 165) for the second, and 159 (95% CI = 156 to 162) per thousand patients/year for the third quintile. Distance and deprivation predicted call rate. Rates were highest for urban areas and lowest for sparse villages and hamlets. The greatest urban/rural variation was in patients aged 0–4 years. Rates were higher in deprived areas, but the effect of deprivation was more evident in urban than rural areas.
Conclusion: There is geographical variation in out-of-hours service use. Patients from rural areas have lower call rates, but deprivation appears to be a greater determinant in urban areas. Geographical barriers must be taken into account when planning and delivering services.
distance, general practice, geographic factors, healthservices accessibility, out-of-hours medical care, ruralhealth
471-477
Turnbull, J.
cd1f8462-d698-4a90-af82-46c39536694b
Martin, D.
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Lattimer, V.
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Pope, C.
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Culliford, D.J.
25511573-74d3-422a-b0ee-dfe60f80df87
July 2008
Turnbull, J.
cd1f8462-d698-4a90-af82-46c39536694b
Martin, D.
e5c52473-e9f0-4f09-b64c-fa32194b162f
Lattimer, V.
5aa2c9a5-13cb-4776-9b0d-c618e6913f5b
Pope, C.
537319b8-553d-4ffd-a9da-7cd840e7a829
Culliford, D.J.
25511573-74d3-422a-b0ee-dfe60f80df87
Turnbull, J., Martin, D., Lattimer, V., Pope, C. and Culliford, D.J.
(2008)
Does distance matter? Geographical variation in GP out-of-hours service use: an observational study.
British Journal of General Practice, 58 (552), .
(doi:10.3399/bjgp08X319431).
(PMID:18611312)
Abstract
Background: GP cooperatives are typically based in emergency primary care centres, and patients are frequently required to travel to be seen. Geography is a key determinant of access, but little is known about the extent of geographical variation in the use of out-ofhours services.
Aim: To examine the effects of distance and rurality on rates of out-of-hours service use.
Design of study: Geographical analysis based on routinely collected data on telephone calls in June (n = 14 482) and December (n = 19 747), and area-level data.
Setting: Out-of-hours provider in Devon, England serving nearly one million patients.
Method: Straight-line distance measured patients’ proximity to the primary care centre. At area level, rurality was measured by Office for National Statistics Rural and Urban Classification (2004) for output areas, and deprivation by The Index of Multiple Deprivation (2004).
Results: Call rates decreased with increasing distance: 172 (95% confidence interval (CI) = 170 to 175) for the first (nearest) distance quintile, 162 (95% CI = 159 to 165) for the second, and 159 (95% CI = 156 to 162) per thousand patients/year for the third quintile. Distance and deprivation predicted call rate. Rates were highest for urban areas and lowest for sparse villages and hamlets. The greatest urban/rural variation was in patients aged 0–4 years. Rates were higher in deprived areas, but the effect of deprivation was more evident in urban than rural areas.
Conclusion: There is geographical variation in out-of-hours service use. Patients from rural areas have lower call rates, but deprivation appears to be a greater determinant in urban areas. Geographical barriers must be taken into account when planning and delivering services.
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More information
Published date: July 2008
Keywords:
distance, general practice, geographic factors, healthservices accessibility, out-of-hours medical care, ruralhealth
Organisations:
Primary Care & Population Sciences, PHEW – P (Population Health), Remote Sensing & Spatial Analysis
Identifiers
Local EPrints ID: 55761
URI: http://eprints.soton.ac.uk/id/eprint/55761
ISSN: 0960-1643
PURE UUID: 6cc4061d-e8fa-49b7-a2be-1f9067dae14b
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Date deposited: 05 Aug 2008
Last modified: 16 Mar 2024 03:38
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Contributors
Author:
V. Lattimer
Author:
C. Pope
Author:
D.J. Culliford
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