Characteristics of general practices associated with numbers of elective admissions

J Public Health (Oxf). 2012 Dec;34(4):584-90. doi: 10.1093/pubmed/fds024. Epub 2012 Mar 23.

Abstract

Background: In England both emergency (unplanned) and non-emergency (elective) hospital admissions have been increasing. Some elective admissions are potentially avoidable.

Aim: to identify the characteristics of general practices and patients associated with elective admissions.

Methods: A cross-sectional study, in Leicestershire, England, was conducted using admission data (2006-07 and 2007-08). Practice characteristics (list size, distance from principal hospital, quality and outcomes framework score and general practitioner (GP) patient access survey data) and patient characteristics (age, ethnicity and deprivation and gender) were used as predictors of elective hospital admissions in a negative binomial regression model.

Results: Practices with a higher proportion of patients aged 65 years or greater and of white ethnicity had higher rates of elective hospital admissions. Practices with more male patients and with more patients reporting being able to consult a particular GP had fewer elective hospital admissions. For 2007-08 practices with a larger list size were associated with higher elective hospital admissions. Quality and outcomes framework performance did not predict admission numbers.

Conclusions: As for unplanned admissions, elective admissions increase as being able to consult a particular GP declines. Interventions to improve continuity should be investigated. Practices face major problems in managing the increased need for planned care as the population ages.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Cross-Sectional Studies
  • England / epidemiology
  • Ethnicity / statistics & numerical data
  • Female
  • General Practice / economics
  • General Practice / standards
  • General Practice / statistics & numerical data*
  • Health Services Accessibility / economics
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Patient Admission / economics
  • Patient Admission / statistics & numerical data*
  • Patient Admission / trends
  • Patient Satisfaction / statistics & numerical data
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Referral and Consultation / economics
  • Referral and Consultation / statistics & numerical data
  • Referral and Consultation / trends
  • Regression Analysis
  • Sex Distribution
  • Socioeconomic Factors
  • White People / statistics & numerical data