Quality of Disease Management and Risk of Mortality in English Primary Care Practices.
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ABSTRACT: Objective
To investigate whether better management of chronic conditions by family practices reduces mortality risk.Data
Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise.Study design
Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures.Principal findings
Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression.Conclusions
The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions.
SUBMITTER: Dusheiko M
PROVIDER: S-EPMC4600356 | biostudies-literature | 2015 Oct
REPOSITORIES: biostudies-literature
Publications
Quality of Disease Management and Risk of Mortality in English Primary Care Practices.
Dusheiko Mark M Gravelle Hugh H Martin Stephen S Smith Peter C PC
Health services research 20150119 5
<h4>Objective</h4>To investigate whether better management of chronic conditions by family practices reduces mortality risk.<h4>Data</h4>Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 other ...[more]
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