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Do practice characteristics explain differences in morbidity estimates between electronic health record based general

C van den Dungen, N Hoeymans, M van den Akker

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    Practice characteristics do not explain variations in morbidity estimates between general practice based registration networks (GPRNs). Differences in electronic health record (EHR) software and province had minor effects, but did not resolve the unexplained variation.

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    Area of Science:

    • Health Informatics
    • General Practice Research
    • Epidemiology

    Background:

    • General practice based registration networks (GPRNs) utilize electronic health records (EHR) for population health data.
    • Significant unexplained variations exist in morbidity estimates derived from different GPRNs.
    • Prior studies indicated population characteristics do not account for these observed differences.

    Purpose of the Study:

    • To investigate the impact of practice characteristics on variations in morbidity estimates.
    • To determine if practice-level factors explain discrepancies between general practices and GPRNs.

    Main Methods:

    • Analyzed eight practice characteristics across six Dutch GPRNs for twelve diseases.
    • Employed multilevel logistic regression analysis to quantify variation using median odds ratios (MOR).
    • Examined EHR software and province influence within a large national GPRN.

    Main Results:

    • Most practice characteristics showed no significant effect on morbidity estimates.
    • Adjusting for practice characteristics did not reduce the variation between practices or GPRNs (MORs remained stable).
    • Specific EHR software ('Medicom') and province ('Groningen') influenced prevalence for some diseases, but minimally reduced overall variation.

    Conclusions:

    • Practice characteristics are not the cause of differing morbidity estimates between GPRNs.
    • The study highlights persistent unexplained variation in morbidity data from GPRNs.