Single-handed versus multiple-handed general practices: A cross-sectional study of quality outcomes in England.
| Title: | Single-handed versus multiple-handed general practices: A cross-sectional study of quality outcomes in England. |
|---|---|
| Authors: | Holdroyd, Ian, Chadwick, William, Harvey-Sullivan, Adam, Bartholomew, Theodore, Massou, Efthalia, Tzortziou Brown, Victoria, Ford, John |
| Source: | Journal of Health Services Research & Policy; Jul2024, Vol. 29 Issue 3, p201-209, 9p |
| Subject Terms: | TREATMENT of diabetes, TUMOR diagnosis, GROUP medical practice, CROSS-sectional method, HEALTH services accessibility, FAMILY medicine, HYPERTENSION, EMERGENCY room visits, MEDICAL office management, PRIMARY health care, MEDICAL care, CONTINUUM of care, CONFIDENCE, TREATMENT effectiveness, DESCRIPTIVE statistics, AGE distribution, HEALTH care reform, PROFESSIONS, HEALTH outcome assessment, PATIENT satisfaction, PUBLIC health, LABOR discipline, CONFIDENCE intervals, DATA analysis software, JOB performance, LABOR supply, REGRESSION analysis |
| Geographic Terms: | ENGLAND |
| Abstract: | Objectives: As general practice increasingly moves towards large group practices, there is debate about the relative benefits, safety and sustainability of different care delivery models. This study investigates the performance of single-handed practices compared to practices with multiple doctors in England, UK. Methods: Practices in England with more than 1000 patients were included. Workforce data and a quality control process classified practices as single-handed or multiple-handed. Outcomes were (i) GP patient survey scores measuring access, continuity, confidence in health professional and overall satisfaction; (ii) reported diabetes and hypertension outcomes; and (iii) emergency department presentation rates and cancer detection (percentage of cancers diagnosed by a 2-week wait). Generalised linear models, controlling for patient and practice characteristics, compared outcomes in single and multiple-handed practices and assessed the effect of GP age in single-handed practices. Results: Single-handed practices were more commonly found in areas of high deprivation (41% compared to 20% of multiple-handed practices). Single-handed practices had higher patient-reported access, continuity and overall satisfaction but slightly lower diabetes management and cancer detection rates. Emergency department presentations were higher when controlling for patient characteristics in single-handed practices but not when also controlling for practice rurality and size. Increased deprivation was associated with lower performance in seven out of eight outcomes. Conclusions: We found single-handed practices to be associated with high patient satisfaction while performing slightly less well on selected clinical outcomes. Further research is required to better understand the association between practice size, including increasing multidisciplinary working, on patient experience and outcomes. [ABSTRACT FROM AUTHOR] |
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| Database: | Complementary Index |
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