Relation between night visit rates and deprivation measures in one general practice

Area of Science:

• General Practice
• Health Services Research
• Socioeconomic Determinants of Health

Background:

• Significant variations in general practice workload exist, potentially linked to socioeconomic factors.
• Understanding these variations is crucial for equitable resource allocation and service delivery.

Purpose of the Study:

• To investigate the relationship between night visit rates and socioeconomic deprivation scores (Jarman and Townsend) and unemployment rates within electoral wards of a single general practice.
• To compare the predictive power of different deprivation indices for general practice workload.

Main Methods:

• Analysis of computerized workload data from a general practice in Mansfield, Nottinghamshire.
• Examined night visit data for 11,998 patients over 588 nights across 15 electoral wards.
• Correlated night visit rates with Jarman Deprivation Score, Townsend Deprivation Score, and local unemployment rates.

Main Results:

• Night visit rates per 1000 patients per year ranged from 19.6 to 55.3 across the 15 electoral wards.
• A statistically significant association was found between night visit rates and the Townsend score (p=0.004) and unemployment rate (p=0.03).
• The Townsend score explained 49% of the variability in night visit rates, unemployment explained 31%, and the Jarman score explained only 9%.

Conclusions:

• A substantial (2.8-fold) variation in night visit rates was observed between electoral wards, even in a practice not receiving deprivation payments.
• The Townsend score demonstrated superior predictive capability for night visit rates compared to the Jarman score within this practice.
• Analyzing internal workload variations in computerized general practices offers a direct method to study the link between socioeconomic deprivation and workload.