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Title: Do practice deprivation scores predict declines in perceived relationship continuity? A longitudinal study.
Authors: Levene, Louis S.
Baker, Richard
Walker, Nicola
Williams, Christopher
Wilson, Andrew
Bankart, John
First Published: Jun-2018
Publisher: Royal College of General Practitioners
Citation: British Journal of General Practice, 2018, 68 (671): e420-e426.
Abstract: Background Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction and fewer hospital admissions. Greater socio-economic deprivation is associated with lower levels of continuity, as well as poorer health outcomes. Aim To investigate whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors. Design and Setting Observational study. Longitudinal multilevel linear model for 2012-2017 inclusive; 6,243 practices in England with more than one GP. Methods Relationship continuity was calculated using two questions from the General Practice Patient Survey. The effect of deprivation on the linear slope of continuity over time was modelled, adjusting for nine confounding variables (practice population and organisational factors). Clustering of measurements within general practices was adjusted for by modelling general practice as a random effect, using a random intercepts and random slopes model. Descriptive statistics and univariable analyses were also undertaken. Results Continuity declined by 27.5% between 2012 and 2017 and at all deprivation levels. Deprivation scores from 2012 did not predict variations in the decline of relationship continuity at practice level, after accounting for the effects of organisational and population confounding variables, which themselves did not predict (smokers, permanent disability and geographical location), or weakly predicted (Black or South Asian ethnicity, list size, over 75s, long-term conditions) with very small effect sizes, the decline of continuity. Crosssectionally, continuity and deprivation were negatively correlated within each year. Conclusion Deprivation scores did not predict decline in relationship continuity over time, which is persistent and widespread in English primary care.
DOI Link: 10.3399/bjgp18X69620
ISSN: 0960-1643
eISSN: 1478-5242
Embargo on file until: 1-Jul-2019
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2018, Royal College of General Practitioners. Deposited with reference to the publisher’s open access archiving policy.
Description: The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, Dept. of Health Sciences

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