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ABSTRACT: Background
The geographical distribution of general practitioners (GPs) is a persistent policy concern within the National Health Service. Maldistribution across family health service authorities in England and Wales fell between 1974 and the mid-1980s but then remained, at best, constant until the mid-1990s.Aim
To estimate levels of maldistribution over the period 1994-2003 and to examine the long-term trend in maldistribution from 1974-2003.Design
Annual snapshots from the GP census.Setting
One hundred 2001 'frozen' health authorities in England and Wales for 1994-2003 and 98 family health service authorities for 1974-1995.Method
Ratios of GPs to raw and need-adjusted populations were calculated for each health authority for each year using four methods of need adjustment: age-related capitation payments, national age- and sex-specific consultation rates, national age- and sex-specific limiting long-term illness rates, and health authority-specific mortality. Three summary measures of maldistribution across health authorities in the GP to population ratio--the decile ratio, the Gini coefficient, and the Atkinson index--were calculated for each year.Results
Maldistribution of GPs as measured by the Gini coefficient and Atkinson index increased from the mid-1980s to 2003, but the decile ratio showed little change over the entire 1974-2003 period. Unrestricted GP principals and equivalents were more equitably distributed than other types of GP.Conclusion
The 20% increase in the number of unrestricted GPs between 1985 and 2003 did not lead to a more equal distribution.
SUBMITTER: Hann M
PROVIDER: S-EPMC1326105 | biostudies-literature | 2004 Dec
REPOSITORIES: biostudies-literature
The British journal of general practice : the journal of the Royal College of General Practitioners 20041201 509
<h4>Background</h4>The geographical distribution of general practitioners (GPs) is a persistent policy concern within the National Health Service. Maldistribution across family health service authorities in England and Wales fell between 1974 and the mid-1980s but then remained, at best, constant until the mid-1990s.<h4>Aim</h4>To estimate levels of maldistribution over the period 1994-2003 and to examine the long-term trend in maldistribution from 1974-2003.<h4>Design</h4>Annual snapshots from ...[more]