Seasonal variations in the process of care in urban general practice

Using data collected for a study of the process of care in a large urban area, the opportunity was taken to examine seasonal variations in consultation patterns. While overall numbers of consultations varied month by month, no seasonal pattern was found. The ratio between patient and doctor-initiated contacts remained stable throughout the year, as did the age, sex and social class of patients consulting. The proportion of consultations that took place in the home increased during the winter months. As expected, seasonal fluctuations in morbidity were most apparent in respiratory disorders, though a small number of non-respiratory problems showed similar variations. There was no discernible seasonal pattern to investigation, referral, and prescribing rates, though wide variation existed between individual general practitioners. The implications of these findings for the design of future studies are discussed.