Skip to main content

Does higher quality primary health care reduce stroke admissions?


Hospital admission rates for stroke are strongly associated with population factors. The supply and quality of primary care services may also affect admission rates, but there is little previous research on this association. In a paper published recently in the British Journal of General Practice, Michael Soljak and colleagues from the Department of Primary Care & Public Health at Imperial College London investigated whether the hospital admission rate for stroke is reduced by effective primary and secondary prevention in primary care.

This was a national cross-sectional study in an English population (52 763 586 patients registered with 7969 general practices in 152 primary care trusts). They found that mean annual stroke admission rates per 100 000 population varied from zero to 476.5 at practice level. In a practice-level multivariable Poisson regression, observed stroke prevalence, deprivation, and smoking prevalence were all risk factors for hospital admission. Protective healthcare factors included the percentage of stroke or transient ischaemic attack patients whose last measured total cholesterol was ≤5 mmol/l, and ability to book an appointment with a GP.

They concluded that the associations of stroke admission rates with deprivation and smoking highlight the need for effective smoking-cessation services. Patient experience of access to primary care may also be clinically important. In countries with well-developed primary healthcare systems, the potential to reduce hospital admissions by further improving the clinical quality of primary healthcare may be limited unless more rigorous quality improvement measures than those currently being used are implemented.

Comments

Popular posts from this blog

Improving how secondary care and general practice in England work together: the NHS Standard Contract

Due to the increasing pressures on general practices within the National Health Service in England, the interface between primary and secondary care, and the division of labour between these, has become an important issue. This has long been an area prone to difficulties and conflict, the consequences of which can directly impact the quality and safety of patient care, particularly for patients with chronic conditions who regularly transition between these two sectors. In an article published in the Journal of the Royal Society of Medicine, Amy Price and I explore the measures recently implemented in the NHS Standard Contract which aim to target common issues at the primary–secondary care interface, with an aim to reducing inappropriate general practitioner workload in England. We discuss the context behind the implementation of the NHS Standard Contract as well as current concerns and areas for further consideration.

The current crisis in primary care means the NHS Standard Contract…

Patients are more satisfied with general practices managed by GP partners than those managed by companies

General practices in England are independent businesses that are contracted to provide primary care for specified populations. Most are owned by general practitioners, but many types of organisation are now eligible to deliver these services. In a study published in the Journal of the Royal Society of Medicine, we examined the association between patient experience and the contract type of general practices in England, distinguishing limited companies from other practices.

We analysed data from the English General Practice Patient Survey 2013–2014 (July to September 2013 and January to March 2014). Patients were eligible for inclusion in the survey if they had a valid National Health Service number, had been registered with a general practice for six months or more, and were aged 18 years or over. All general practices in England with eligible patients were included in the survey (n = 8017).

Patients registered to general practices owned by limited companies reported worse experience…

Dr Demis Hassabis, Co-Founder and CEO of DeepMind, Speaks about AI in Healthcare

On 28 September 2017, I attended the Annual Institute of Global Health Innovation Lecture: Artificial General Intelligence and Healthcare, delivered by Dr Demis Hassabis, co-founder and CEO of Google DeepMind. Artificial intelligence is the science of making machines smart argued Dr Hassabis, so how can we make it improve the healthcare sector? Dr Hassabis then went on to describe the work that DeepMind was carrying out in healthcare in areas such as organising information, deep learning to support the reporting of medical images (such as scans and pathology slides), and biomedical science. Dr Hassabis also discussed the challenges of applying techniques such as reinforcement learning in healthcare. He concluded that artificial intelligence has great scope for improving healthcare; for example, by prioritising the tasks that clinicians had to carry out and by providing decision support aids for both patients and doctors. Dr Hassabis also discussed some of the ethical issues in using …