The construction of a decision tool to analyse local demand and local supply for GP care using a synthetic estimation model

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

This study addresses the growing academic and policy interest in the appropriate provision of local healthcare services to the healthcare needs of local populations to increase health status and decrease healthcare costs. However, for most local areas information on the demand for primary care and supply is missing. The research goal is to examine the construction of a decision tool which enables healthcare planners to analyse local supply and demand in order to arrive at a better match.

Methods

National sample-based medical record data of general practitioners (GPs) were used to predict the local demand for GP care based on local populations using a synthetic estimation technique. Next, the surplus or deficit in local GP supply were calculated using the national GP registry. Subsequently, a dynamic internet tool was built to present demand, supply and the confrontation between supply and demand regarding GP care for local areas and their surroundings in the Netherlands.

Results

Regression analysis showed a significant relationship between sociodemographic predictors of postcode areas and GP consultation time ( F [14, 269,467] = 2,852.24; P <0.001). The statistical model could estimate GP consultation time for every postcode area with >1,000 inhabitants in the Netherlands covering 97% of the total population. Confronting these estimated demand figures with the actual GP supply resulted in the average GP workload and the number of full-time equivalent (FTE) GP too much/too few for local areas to cover the demand for GP care. An estimated shortage of one FTE GP or more was prevalent in about 19% of the postcode areas with >1,000 inhabitants if the surrounding postcode areas were taken into consideration. Underserved areas were mainly found in rural regions.

Conclusions

The constructed decision tool is freely accessible on the Internet and can be used as a starting point in the discussion on primary care service provision in local communities and it can make a considerable contribution to a primary care system which provides care when and where people need it.

Related collections

Most cited references 19

Record: found
Abstract: found
Article: not found

Gender differences in the utilization of health care services.

K D Bertakis, R Azari, L J Helms … (2000)

Studies have shown that women use more health care services than men. We used important independent variables, such as patient sociodemographics and health status, to investigate gender differences in the use and costs of these services. New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of health care services and associated charges were monitored for 1 year of care. Self-reported health status was measured using the Medical Outcomes Study Short Form-36 (SF-36). We controlled for health status, sociodemographic information, and primary care physician specialty in the statistical analyses. Women had significantly lower self-reported health status and lower mean education and income than men. Women had a significantly higher mean number of visits to their primary care clinic and diagnostic services than men. Mean charges for primary care, specialty care, emergency treatment, diagnostic services, and annual total charges were all significantly higher for women than men; however, there were no differences for mean hospitalizations or hospital charges. After controlling for health status, sociodemographics, and clinic assignment, women still had higher medical charges for all categories of charges except hospitalizations. Women have higher medical care service utilization and higher associated charges than men. Although the appropriateness of these differences was not determined, these findings have implications for health care.

0 comments Cited 380 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care.

J. Ramsay, John Campbell, J Green (2001)

Patients' evaluations are an important means of measuring aspects of primary care quality such as communication and interpersonal care. This study aims to examine variations in assessments of primary care according to age, gender, socioeconomic, and ethnicity variables. A cross sectional survey of consecutive patients attending 55 inner London practices was performed over a 2 week period using the General Practice Assessment Survey (GPAS) instrument which assesses 13 important dimensions of primary care provision. Variations in scale scores were investigated for differences relating to age, gender, socioeconomic, and ethnic status as reported by respondents. A total of 7692 questionnaires were returned (71% response rate). Valid information on age, gender, socioeconomic status, and ethnicity was available for 4819 out of 5496 adult respondents. Approximately half the respondents reported their ethnic group as "white" and most of the remaining respondents reported belonging to "black" or South Asian groups. Significant differences existed between groups of patients defined by age or ethnicity for most of the scale scores examined. Black, South Asian, and Chinese respondents reported lower scores (representing less favourable assessments) than white respondents; older respondents reported more favourable evaluations of care than younger respondents; and less affluent groups reported lower scores than more affluent groups for two of the 13 dimensions. There was no significant difference between gender groups with respect to assessment of primary care. Age and ethnicity were independent predictors of respondents' assessments of primary care. Differences exist between identifiable subgroups of the population in their assessments of primary health care measured using the GPAS instrument. This work adds to the literature on variation in healthcare experience and the potential for patient assessment of primary care. Further work is required to investigate these differences in more detail and to relate them to differences in the nature and process of primary care provision. Primary care providers need to ensure that services provided are appropriate for all patient groups within their communities.

0 comments Cited 87 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Immigrants in the Netherlands: equal access for equal needs?

A C J Ravelli, K. Stronks, Menno Reijneveld (2001)

This paper examines whether equal utilisation of health care services for first generation immigrant groups has been achieved in the Netherlands. Survey data were linked to an insurance register concerning people aged 16-64. Ethnic differences in the use of a broad range of health care services were examined in this group, with and without adjustment for health status and socioeconomic status, using logistic regression. Publicly insured population in Amsterdam, the Netherlands. 1422 people from the indigenous population, and 378 people from the four largest immigrant groups in the Netherlands-that is, the Surinamese, the Netherlands Antilleans, and the Turkish and Moroccan. General practitioner service use (past two months), prescription drug use (past three months), outpatient specialist contact (past two months), hospital admission (past year), physiotherapist contact (past two months) and contact with other paramedics (past year). Ethnicity was found to be associated with the use of health care after controlling for health status as an indicator for need. The use of general practitioner care and the use of prescribed drugs was increased among people from Surinam, Turkey and Morocco as compared with the indigenous population. Compared with the indigenous group with corresponding health status, the use of all other more specialised services was relatively low among Turkish and Moroccan people. Among the Surinamese population, the use of more specialised care was highly similar to that found in the Dutch population after differences in need were controlled for. Among people from the Netherlands Antilles, we observed a relatively high use of hospital services in combination with underuse of general practitioner services. The lower socioeconomic status of immigrant groups explained most of the increased use of the general practitioner and prescribed drugs, but could not account for the lower use of the more specialised services. The results indicate that the utilisation of more specialised health care is lower for immigrant groups in the Netherlands, particularly for Turkish and Moroccan people and to a lesser extent, people from the Netherlands Antilles. Although underuse of more specialised services is also present among the lower socioeconomic groups in the Netherlands, the analyses indicate that this only partly explains the lower utilisation of these services among immigrant groups. This suggests that ethnic background in itself may account for patterns of consumption, potentially because of limited access.

0 comments Cited 65 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Willemijn A de Graaf-Ruizendaal

Dinny H de Bakker

Journal

Journal ID (nlm-ta): Hum Resour Health

Journal ID (iso-abbrev): Hum Resour Health

Title: Human Resources for Health

Publisher: BioMed Central

ISSN (Electronic): 1478-4491

Publication date Collection: 2013

Publication date (Electronic): 27 October 2013

Volume: 11

Page: 55

Affiliations

[1 ]Department of Primary Care Organization, NIVEL: Netherlands Institute for Health Service Research, PO Box 1568, 3500 BN Utrecht, The Netherlands

[2 ]Department for Social and Behavioural Science, Tranzo Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands

Article

Publisher ID: 1478-4491-11-55

DOI: 10.1186/1478-4491-11-55

PMC ID: 4231547

PubMed ID: 24161015

SO-VID: ffdb02e7-1efe-4fc9-9443-c0cde5b69ac8

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The construction of a decision tool to analyse local demand and local supply for GP care using a synthetic estimation model

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Tobacco Prevention & Cessation

Most cited references 19

Gender differences in the utilization of health care services.

Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care.

Immigrants in the Netherlands: equal access for equal needs?

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 57

Cited by 9

Most referenced authors 160