Abstract
BackgroundGeneral practice based registration networks (GPRNs) provide information on morbidity rates in the population. Morbidity rate estimates from different GPRNs, however, reveal considerable, unexplained differences. We studied the range and variation in morbidity estimates, as well as the extent to which the differences in morbidity rates between general practices and networks change if socio-demographic characteristics of the listed patient populations are taken into account.MethodsThe variation in incidence and prevalence rates of thirteen diseases among six Dutch GPRNs and the influence of age, gender, socio economic status (SES), urbanization level, and ethnicity are analyzed using multilevel logistic regression analysis. Results are expressed in median odds ratios (MOR).ResultsWe observed large differences in morbidity rate estimates both on the level of general practices as on the level of networks. The differences in SES, urbanization level and ethnicity distribution among the networks' practice populations are substantial. The variation in morbidity rate estimates among networks did not decrease after adjusting for these socio-demographic characteristics.ConclusionSocio-demographic characteristics of populations do not explain the differences in morbidity estimations among GPRNs.
Highlights
General practice based registration networks (GPRNs) provide information on morbidity rates in the population
In this paper we investigate the effect of differences in patient characteristics on variation in morbidity estimations among general practice registration networks (GPRNs)
Before investigating the effect of socio-demographic characteristics on the variation in morbidity among GPRNs, we studied the variation between networks and practices
Summary
General practice based registration networks (GPRNs) provide information on morbidity rates in the population. Using data generated by general practice registration networks (GPRNs) to estimate morbidity has many advantages, especially in countries with a strong primary care system, like the United Kingdom and the Netherlands [3,4,5]. In these countries, all non-institutionalized residents are listed with a single general practitioner (GP), which makes a precise determination of the population at risk possible. There are GPRNs that include all morbidity presented in general practice, ‘episode based’ registries, while others only van den Dungen et al BMC Public Health 2011, 11:887 http://www.biomedcentral.com/1471-2458/11/887 record chronic or very serious conditions into their database, called ‘problem based’ registries [4]
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