Long term condition morbidity in English general practice: a cross-sectional study using three composite morbidity...

Area of Science:

• General Practice Research
• Health Services Research
• Chronic Disease Management

Background:

• General practices experience substantial variation in the burden of patients with long-term conditions (LTCs).
• Understanding the characteristics of practices with high morbidity burden is crucial for effective healthcare delivery.

Purpose of the Study:

• To identify the key characteristics of general practices exhibiting a high burden of long-term conditions.
• To analyze the determinants of morbidity burden at the practice level.

Main Methods:

• A retrospective cross-sectional study of 7779 general practices in England (2014/15).
• Three composite morbidity measures (MMs) were developed using Quality and Outcomes Framework (QOF) data and the GP Patient Survey (GPPS).
• Multi-level regression models analyzed determinants including practice and patient demographics, and secondary care utilization.

Main Results:

• Morbidity measure scores varied widely across practices.
• Elderly patient proportion and social deprivation were the strongest predictors of morbidity burden.
• Morbidity burden was largely independent of practice characteristics but predicted higher secondary care utilization and lower patient satisfaction.

Conclusions:

• LTC morbidity burden varies significantly across English general practices, influenced by patient demographics rather than practice attributes.
• Higher morbidity burden correlates with increased secondary care utilization and decreased patient satisfaction, impacting resource allocation and commissioning.
• A standardized metric for assessing morbidity and multimorbidity burden in general practice is needed.