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Related Experiment Videos

The denominator for audit in general practice.

D M Fleming

    Family Practice
    |June 1, 1985
    PubMed
    Summary

    Choosing the right denominator is key for morbidity studies. For general practice audits, using the number of consultations over two weeks is a suitable proxy for persons consulting when rank order is important.

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    Area of Science:

    • General Practice
    • Epidemiology
    • Health Services Research

    Background:

    • Accurate denominators are crucial for interpreting morbidity data in primary care.
    • Previous studies have used various denominators, including 'list size', 'persons consulting', and 'consultations'.
    • The choice of denominator can impact the perceived morbidity rates and audit findings.

    Purpose of the Study:

    • To compare different denominators used in morbidity studies in British general practice.
    • To assess the correlation between 'persons consulting', 'list size', and 'consultations' as denominators.
    • To determine the suitability of 'consultations' as a proxy for 'persons consulting' in specific audit contexts.

    Main Methods:

    • Analysis of data from two large British studies: the second national morbidity survey and a practice activity analysis.
    • Statistical comparison of correlations between different denominators ('persons consulting', 'list size', 'consultations').
    • Evaluation of rank order statistics for visiting and out-patient referral rates based on chosen denominators.

    Main Results:

    • A strong correlation (r > 0.9) was found between 'persons consulting' and 'list size' in the national morbidity survey.
    • A weaker correlation (r = 0.6) was observed between 'consultations' and 'list size'.
    • In the practice activity analysis, 'persons consulting' and 'total consultations' showed a very high correlation (r = 0.99) over a two-week period.
    • The choice of denominator had minimal impact on rank order statistics for most doctors, except those at the extremes of the consultation rate range.

    Conclusions:

    • The number of consultations over two weeks can serve as a satisfactory proxy for 'persons consulting' in general practice audits.
    • This approach is appropriate when rank order interpretation is suitable for the data.
    • The findings support the use of 'consultations' as a practical and reliable denominator in specific primary care audit scenarios.

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