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Socioeconomic differences in general practice consultation rates in patients aged 65 and over: prospective cohort
Objective:
To examine socioeconomic differences in general practice consultation rates among patients aged 65 years and over.
Design:
Secondary analysis of data from the fourth national survey of morbidity in general practice.
Setting:
60 general practices in England and Wales.
Subjects:
71 984 people aged 65 years and over.
Main Outcome Measures:
Annual contact rates and home visiting rates with general practitioners and practice nurses.
Results:
Social class differences in tact rates were greatest in 65-74 year olds, with rates 23% higher in patients from social class V than in class I (4.82 v 3.93 per person). In 75-84 year olds there was no clear association between social class and contact rates, and in people aged >/=85 years contact rates were highest in patients from class I. Home visiting rates were twice as high in patients from class V as in patients from class I (1.38 v 0.66 per person). Contact rates were 17% higher in people living in communal establishments and 8% higher in those living alone than in those living with others but not in a communal establishment. 66% of contacts with patients in communal establishments and 26% of those with patients living alone were in patients' homes compared with 18% with those living in standard accommodation. These differences persisted after adjustment in a generalised linear model.
Conclusions:
Elderly people show socioeconomic differences in consultation rates. The extra workload generated by elderly people living alone and in communal establishments suggests additional payments to general practitioners are needed.