Article Figures & Data
Tables
- Table 1. Summary of available DES and proportions of practices offering each service, N = 6849
DES Practices offering service, n (%) Influenza and pneumococcal immunisations 6844 (99.9) Rotavirus and shingles immunisation 6839 (99.9) Meningitis immunisation 6829 (99.7) Childhood vaccination and immunisations 6820 (99.6) Pertussis immunisation 6708 (97.9) Learning disabilities health checks 5776 (84.3) Minor surgery 5240 (76.5) Extended hours access 4961 (72.4) Violent patient services 134 (2.0) Out-of-area, in-hours urgent care 89 (1.3) DES = directed enhanced service.
- Table 2. Demographic and practice determinants of DES funding (£/patient): adjusted regression model
Predictor variable DES funding model: regression coefficient, B (95% CI) Practice list size (per 10 000 registered patients) 0.44 (0.32 to 0.56)a Single-handed practice –0.01 (–0.26 to 0.24) Practice staffing (number of staff per 10 000 registered patients) GPs 0.09 (0.07 to 0.12)a Practice nurses 0.15 (0.11 to 0.19)a Administrative staff 0.01 (–0.01 to 0.03) Direct patient care staff (for example, clinical pharmacists) 0.08 (0.05 to 0.11)a Age of registered patients, years 0–4 33.2 (26.0 to 40.4)a 5–14 –0.49 (–4.33 to 3.36) 45–64 7.49 (5.22 to 9.75)a ≥65 3.30 (1.38 to 5.23)b Social deprivation quintiles of registered patients Deprivation quintile 1 (least deprived) ref Deprivation quintile 5 (most deprived) –0.35 (–0.60 to –0.10)b Deprivation quintile 4 –0.09 (–0.30 to 0.13) Deprivation quintile 3 –0.03 (–0.22 to 0.17) Deprivation quintile 2 0.02 (–0.16 to 0.21) Ethnic group of registered patients Black –1.45 (–2.92 to 0.02) Asian 0.65 (0.07 to 1.23)c Region East of England ref London –0.30 (–0.58 to –0.02)c Midlands 0.24 (0.01 to 0.47)c North East and Yorkshire 0.49 (0.24 to 0.73)a North West 0.19 (–0.07 to 0.44) South East 0.003 (–0.24 to 0.25) South West 0.81 (0.32 to 1.10)a Practice income (£/100 patients) Capitation payments –0.01 (–0.02 to –0.01)a QOF payments 0.15 (0.13 to 0.18)a MPIG payments 0.01 (–0.14 to 0.11) Assocations with each predictor are adjusted for the effect of all other predictors in the Table. asignificant, P<0.001. bsignificant, P<0.01. csignificant, P<0.05. DES = directed enhanced services. QOF = Quality and Outcomes Framework. MPIG = minimum practice income guarantee.
- Table 3. Demographic and practice determinants of individual components of DES funding (£/patient): adjusted regression model
Predictor variable Influenza & pneumococcal immunisation Rotavirus & shingles immunisation Meningitis immunisation Childhood immunisations Pertussis immunisation Learning disabilities checks Minor surgery Extended hours access Violent patient services Out of area, in-hours urgent care Adj. R2: 0.50 Adj. R2: 0.29 Adj. R2: 0.39 Adj. R2: 0.19 Adj. R2: 0.21 Adj. R2: 0.11 Adj. R2: 0.09 Adj. R2: 0.08 Adj. R2: 0.09 Adj. R2: 0.002 Age of registered patients, years (comparator: 15–44) Regression coefficient, B (95% CI) 0–4 0.48(–1.29 to 2.25) 1.78a(1.58 to 1.98) 5.24a(4.95 to 5.53) 18.7a(16.5 to 20.9) 0.98b(0.89 to 1.08) 0.09(–0.98 to 1.15) 1.37(–2.95 to 5.69) 2.69(–0.32 to 5.71) 1.39(–1.82 to 4.61) –0.01(–0.07 to 0.04) 5–14 0.77(–0.18 to 1.71) –0.22a(–0.33 to –0.11) –0.72a(–0.88 to –0.57) 1.65b(0.47 to 2.83) –0.19a(0.24 to –0.14) 0.80b(0.23 to 1.37) –0.004(–2.31 to 2.30) 0.46(–1.14 to 2.06) –3.04b(–4.75 to –1.33) –0.0004(–0.03 to 0.03) 45–64 0.69c(0.14 to 1.24) 0.04(–0.02 to 0.10) –0.09(–0.18 to 0.01) 1.95a(1.26 to 2.65) 0.02(–0.11 to 0.06) 0.24(–0.09 to 0.57) 2.05b(0.69 to 3.40) 1.36b(0.42 to 2.30) 1.35b(0.35 to 2.35) 0.007(–0.02 to 0.01) ≥65 5.71a(5.24 to 6.18) 0.54a(0.49 to 0.60) –0.30a(–0.38 to 0.22) –0.79(–1.38 to –0.20) –0.09(–0.11 to –0.06) –0.37c(–0.65 to –0.08) 2.17a (1.01 to 3.32) –1.02c(–1.82 to –0.21) –2.43a(–3.29 to –1.58) –0.003(–0.02 to 0.01) Social deprivation (most deprived compared with least deprived quintile) –0.15a(–0.21 to –0.08) –0.02a(–0.03 to 0.02) –0.03a(–0.04 to –0.02) –0.12b(–0.20 to –0.05) –0.01a(–0.02 to –0.01) 0.10a(0.07 to 0.14) 0.11(–0.04 to 0.26) –0.24a(–0.35 to –0.14) 0.03(–0.08 to 0.14) –0.001(–0.003 to 0.001) Black ethnic group (compared with White ethnic group) 0.08(–0.28 to 0.44) –0.02(–0.06 to 0.02) –0.02(–0.08 to 0.04) –1.09a(–1.54 to –0.64) –0.04a(0.06 to –0.01) –0.26c(–0.47 to –0.04) –0.66(–1.54 to 0.22) 0.82b(0.20 to 1.43) –0.45(–1.10 to 0.21) 0.001(–0.01 to 0.01) Asian ethnic group (compared with White ethnic group) 0.37a(0.23 to 0.52) –0.01(–0.02 to 0.01) 0.01(–0.01 to 0.04) 0.08(–0.10 to 0.26) –0.02(–0.01 to 0.02) 0.07(–0.02 to 0.15) 0.16(–0.19 to 0.51) 0.06(–0.19 to 0.30) –0.03(–0.23 to 0.29) 0.002(–0.002 to 0.006) The B coefficients displayed are adjusted for all predictors included in the original regression model, Table 2. For simplicity, only age, deprivation, and ethnic group predictors are shown in this Table.
Adjusted R2 values refer to values for the regression model for each individual directed enhanced services (DES) component. asignificant, P<0.001. bsignificant, P<0.01. csignificant, P<0.05.