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Partnership effects in general practice: identification of clustering using intra-class correlation coefficients
Mark Ashworth1, David Armstrong
1Department of General Practice and Primary Care, Guy's, King's and St Thomas' School of Medicine, King's College London, 5 Lambeth Walk, London SE11 6SP. mark.ashworth@gp-G85053.nhs.uk
Summary
General practitioners' (GPs) partnerships in the UK show distinct attitudes. While prescribing views are individual, managerial opinions strongly align within partnerships, indicating shared decision-making in practice management.
Area of Science:
- Health Services Research
- General Practice
- Medical Management
Background:
- Most United Kingdom general practitioners (GPs) operate within partnership structures.
- The internal dynamics and attitudinal homogeneity of these GP partnerships remain under-explored.
Purpose of the Study:
- To investigate the nature of general practice partnerships in the UK.
- To examine GP partners' attitudes towards prescribing and managerial issues within commissioning groups.
- To explore attitudinal clustering within partnerships using Intra-class Correlation Coefficients (ICCs).
Main Methods:
- A survey was conducted with 61 general practice partners across 15 group practices.
- Intra-class Correlation Coefficients (ICCs) were calculated to assess attitude homogeneity.
- Attitudes towards prescribing and managerial issues were analyzed.
Main Results:
- Low ICCs for prescribing attitudes indicated individual GP decision-making.
- High ICCs for managerial issues demonstrated strong attitudinal clustering within partnerships.
- Managerial attitudes appear to be more commonly shared within GP partnerships than prescribing attitudes.
Conclusions:
- General practice partnerships exhibit heterogeneity in attitudinal sharing.
- Managerial aspects of practice are more likely to be collectively held within partnerships.
- ICCs are valuable for analyzing homogeneity and heterogeneity in general practice settings.