ID-5184 Wonca Abstracts supplement L-Z 13-10-23 - Flipbook - Page 29
WONCA 2023 Supplement 2: WONCA 2023 abstracts (L–Z)
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Patient self-reported health and the impact of primary care
funding: A national longitudinal study of English general
practices, 2013–16
Dr Veline L’esperance, Mark Ashworth
King’s College London
Objectives
To examine the relationship between self-reported health of patients in general practices, as measured
by EQ-5D-5L, with practice funding and practice characteristics.
Methods
We combined six datasets for all English general practices (n = 7310) using data for the financial
years 2013–14 to 2016–17: (1) General and Personal Medical Services database, providing workforce
and patient data; (2) NHS payments to General Practice, which records payments to practices; (3)
Quality and Outcomes Framework describing performance on clinical achievement of clinical quality
indicators; (4) deprivation data for each practice; (5) neighbourhood ethnicity profile for each practice;
and (6) practice-level patient experience scores and EQ-5D-5L index from the General Practice Patient
Survey. We use data from the GP Patient Survey (GPPS) to construct a practice level EQ-5D-5L
index as the health outcome in dimensions of mobility, self-care, usual activities, pain and anxiety.
Key explanatories are general practice funding, practice deprivation, patient-reported measures of
satisfaction, clinical achievement and practice morbidity (proportion of patients with one or more
chronic condition). We estimate practice-level panel data models with random and fixed practice
effects and practice and patient explanatories.
Results
Mean total funding per patient at 2016 prices was £133.66 (standard deviation £39.46). In both random
and fixed-effects panel regressions, general practice funding is positively associated with one-year
lags of general practice funding across each of five dimensions of health: mobility, self-care, usual
activities, pain/discomfort and anxiety/depression. Each of the five dimensions of health are also
positively associated with one-year lags of patient satisfaction and clinical quality. However, higher
levels of deprivation and practice morbidity are associated with lower health outcomes across all
health dimensions.
Discussion
Practice-level EQ-5D-5L for each health dimension is positively associated with practice funding,
patient-reported satisfaction and clinical achievement, but negatively associated with deprivation and
practice morbidity.
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