Primary care needs assessment and resourcing: complementary practice and geographic perspectives.

Area of Science:

• Health Services Research
• Public Health
• Health Economics

Background:

• Primary care resource allocation often relies on patient age, potentially overlooking socio-economic factors.
• Socio-economic deprivation is a known determinant of health needs and healthcare utilization.
• Small area census data offers a granular approach to assessing socio-economic status at a practice level.

Purpose of the Study:

• To derive socio-economic health need indices using small area census data for primary care practices.
• To assess the relationship between these indices and primary care practice activity.
• To inform resourcing formulae by incorporating deprivation's impact alongside patient age.

Main Methods:

• Utilized small area census data to construct socio-economic health need indices.
• Conducted a case study in an East London health authority (380,000 population, 97 practices).
• Analyzed practice activity data (inpatient/outpatient referrals, prescribing) in relation to age and deprivation.

Main Results:

• Practice deprivation significantly influenced total referral rates and prescribing, even after accounting for patient age.
• The effect of deprivation was more pronounced for specific referral types, such as emergency department visits.
• Practice characteristics, like the number of general practitioners relative to the patient population, had minimal impact on activity once age and deprivation were considered.

Conclusions:

• Socio-economic deprivation is a crucial factor in primary care activity and should be integrated into health needs assessments.
• Resourcing formulae for primary care should incorporate deprivation weightings to ensure equitable resource distribution.
• This approach can lead to a better alignment between healthcare needs and available resources at both practice and local levels.