Home visiting by general practitioners in England and Wales

Area of Science:

• General Practice
• Health Services Research
• Epidemiology

Background:

• Home visits are a significant part of general practitioners' (GPs) workload.
• Understanding factors influencing home visit rates is essential for resource allocation and service delivery.

Purpose of the Study:

• To investigate the association between patient characteristics and home visiting rates in general practice.
• To analyze variations in home visiting patterns across different patient demographics and social classes.

Main Methods:

• Utilized data from the fourth national survey of morbidity in general practice.
• Analyzed diagnostic data from home visits conducted by GPs in 60 practices across England and Wales.
• Calculated home visiting rates per 1000 patient-years and standardized ratios for age and sex.

Main Results:

• Home visits constituted 10.1% of GP contacts.
• Home visiting rates exhibited a J-shaped relationship with age, peaking in the elderly (≥85 years).
• Higher social classes (IV and V) had significantly higher standardized home visiting ratios compared to social class I.
• A small proportion of patients (1.3%) received a disproportionately high number of visits (39%).
• Considerable variation in home visiting rates was observed between general practices.

Conclusions:

• Home visits remain a vital component of GP services.
• Patient characteristics, particularly age and social class, are strongly associated with home visiting frequency.
• Significant inter-practice variability in home visiting rates suggests potential for workload disparities.
• Further research into high-utilizing patients could inform resource allocation and workload management in general practices.