Socioeconomic differences in case finding among general practices in England: analysis of secondary data

To determine how levels of case finding differ between general practices in England by level of population socio-economic deprivation.

Observational analysis of data from the Quality and Outcome Framework in England for 2005/06. It covered 8339 primary care practices. Reported prevalence and estimated prevalence for coronary heart disease, chronic obstructive pulmonary disease, stroke and hypertension were compared.

The gap between estimated and reported prevalence increased with population deprivation and was higher among practices in more deprived areas (defined as Spearhead areas) for all four conditions after adjustment for practice level variables.

There is some evidence of unmet need in areas of social deprivation. Existing financial incentives in the Quality and Outcome Framework may be insufficient to promote active case finding by practices serving deprived populations.