Monitoring the death rates of general practitioners' patients in a single Health Authority

Pinder, D. C.

doi:10.1093/pubmed/24.3.230

Journal of Public Health

2002

DOI: 10.1093/pubmed/24.3.230

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Monitoring the death rates of general practitioners' patients in a single Health Authority

D. C. Pinder¹

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Cited by 2 publications

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“…For example, the proportion of nursing home patients is one of a number of case-mix factors that can affect mortality rates calculated for GP practices (which are similar in size to UK electoral wards). [12][13][14] This paper examines the impact of the uneven distribution of nursing homes on LE calculations for small areas, such as UK electoral wards.…”

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Impact of nursing home deaths on life expectancy calculations in small areas

Williams¹,

Dinsdale

Eayres³

et al. 2004

Journal of Epidemiology & Community Health

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Study objective: The drive to tackle health inequalities at the local level has increased interest in mortality data for small populations. There is some concern that nursing homes may affect measures of mortality for small populations, but there has been little in depth analysis of this. Design and setting: Deaths between 1997 and 2001 and population figures from the GP register (Exeter) database and census 2001 were used to produce life expectancy (LE) figures for all electoral wards in West Sussex. The proportion of those dying within each ward that had been residents of nursing homes was calculated and the relation between these variables and deprivation investigated.Results: There was a significant linear relation between nursing home deaths and LE (p,0.0001), which explained 36% of variation in LE between wards. Deprivation accounted for around 35% of the variation in LE (p,0.0001) but was not correlated with nursing home deaths (p>0.0982). Multiple linear regression shows that over 60% of the variation in LE at ward level can be explained by both nursing home deaths and deprivation (p,0.0001) and that the two variables explain similar proportions of this variation. The relation between LE and nursing home deaths within wards grouped by deprivation suggests that the impact of nursing homes is strongest in deprived wards. Conclusions: This finding has important implications for LE calculations in small populations. Further investigation is now needed to examine the impact of nursing homes in other areas, on other mortality measures, and in larger populations.

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confidence: 99%

Impact of nursing home deaths on life expectancy calculations in small areas

Williams¹,

Dinsdale

Eayres³

et al. 2004

Journal of Epidemiology & Community Health

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Making use of mortality data to improve quality and safety in general practice: a review of current approaches

Baker

Sullivan

Camosso‐Stefinovic

et al. 2007

Quality and Safety in Health Care

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Objective: To review studies of the use of mortality data in quality and safety improvement in general practice. Design: Narrative review. Methods: Search of Medline, Embase and CINAHL for articles reporting mortality monitoring or mortality reviews in general practice. The included articles were reported in English and of any study design, excluding case reports and comment pieces. Studies of palliative care and bereavement, and of primary care programmes in developing countries, were excluded. Results: 229 articles were identified in the searches, 65 were identified as potentially relevant and 53 were included in the review. The studies addressed the impact of primary care provision on mortality rates, methods of monitoring mortality, and the role of audit and death registers in quality and safety improvement. General practitioners were interested in using mortality data but reported difficulties in obtaining complete information. There were no experimental studies of the impact of the use of mortality data, and little evidence of long-term systematic initiatives to use mortality data in quality and safety improvement in general practice. Conclusions: Mortality data are not used systematically in general practice although general practitioners appear interested in the potential of this information in improving quality and safety. Improved systems to provide complete data are needed and experimental studies required to determine the effectiveness of use of the data to improve general practice care.

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Monitoring the death rates of general practitioners' patients in a single Health Authority

Cited by 2 publications

References 2 publications

Impact of nursing home deaths on life expectancy calculations in small areas

Impact of nursing home deaths on life expectancy calculations in small areas

Making use of mortality data to improve quality and safety in general practice: a review of current approaches

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