Ongoing Decline in Continuity With GPs in English General Practices: A Longitudinal Study Across the COVID-19 Pandemic.

Purpose: Relationship continuity of care has declined across English primary health care, with cross-sectional and longitudinal variations between general practices predicted by population and service factors. We aimed to describe cross-sectional and longitudinal variations across the COVID-19 pandemic and determine whether practice factors predicted the variations.

Methods: We conducted a longitudinal, ecological study of English general practices during 2018-2022 with continuity data, excluding practices with fewer than 750 patients or National Health Service (NHS) payments exceeding £500 per patient.

Does shortage of GPs matter? A cross-sectional study of practice population life expectancy.

Background: There are not enough GPs in England. Access to general practice and continuity of care are declining.

Aim: To investigate whether practice characteristics are associated with life expectancy of practice populations.

Variations in documentation of atrial fibrillation predicted by population and service level characteristics in primary health care in England.

Background: Identifying features associated with atrial fibrillation (AF) documentation could inform screening. This study used published data to describe differences in documented and estimated AF prevalence in general practices, and explored predictors of variations in AF prevalence.

Methods: Cross-sectional study of 7318 general practices in England.

Predictors of hypertension detection in English general practices: a cross sectional study.

Background: Worldwide, high systolic blood pressure is the leading risk factor for deaths and disability-adjusted life-years but has been historically under-detected. This study aimed to quantify differences between estimated and practice-detected prevalences of hypertension across English general practices, and to determine how variations in detected prevalence could be explained by population-level and service-level factors.

Methods: Descriptive statistics, pair wise correlations between the independent variables and a multivariable regression analysis were undertaken.

Socioeconomic deprivation scores as predictors of variations in NHS practice payments: a longitudinal study of English general practices 2013-2017.

Background: A previous study found that variables related to population health needs were poor predictors of cross-sectional variations in practice payments.

Aim: To investigate whether deprivation scores predicted variations in the increase over time of total payments to general practices per patient, after adjustment for potential confounders.

Design And Setting: Longitudinal multilevel model for 2013-2017; 6900 practices (84.

Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in primary care.

Background: Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction, and fewer hospital admissions. Greater socioeconomic deprivation is associated with lower levels of continuity, as well as poorer health outcomes.

Aim: To investigate whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors.

Variations in coronary mortality rates between English primary care trusts: observational study 1993-2010.

Background: In England, coronary heart disease (CHD) mortality has declined, but variations remain.

Methods: This study aimed to describe under 75-year CHD mortality variations across geographically defined populations. Regression slopes for mortality data as a function of time were calculated for all 151 English primary care trusts (PCTs), giving the change in the expected age adjusted rate for each extra year.

Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013-2014 and 2014-2015.

Background: NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups.

Aim: To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England.

Design And Setting: Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015.

Population characteristics, mechanisms of primary care and premature mortality in England: a cross-sectional study.

Objectives: Health systems with strong primary care tend to have better population outcomes, but in many countries demand for care is growing. We sought to identify mechanisms of primary care that influence premature mortality.

Design: We developed a conceptual model of the mechanisms by which primary care influences premature mortality, and undertook a cross-sectional study in which population and primary care variables reflecting the model were used to explain variations in mortality of those aged under 75 years.

Association of primary care characteristics with variations in mortality rates in England: an observational study.

Background: Wide variations in mortality rates persist between different areas in England, despite an overall steady decline. To evaluate a conceptual model that might explain how population and service characteristics influence population mortality variations, an overall null hypothesis was tested: variations in primary healthcare service do not predict variations in mortality at population level, after adjusting for population characteristics.

Methodology/principal Findings: In an observational study of all 152 English primary care trusts (geographical groupings of population and primary care services, total population 52 million), routinely available published data from 2008 and 2009 were modelled using negative binomial regression.

Association of features of primary health care with coronary heart disease mortality.

Context: The goal of US health care reform is to extend access. In England, with a universal access health system, coronary heart disease (CHD) mortality rates have decreased by more than two-fifths in the last decade, but variations in rates between local populations persist.

Objective: To identify which features of populations and primary health care explain variations in CHD mortality rates between the 152 primary care trust populations in England.

How likely is it that a district health authority can close its large mental hospitals?

A cross-sectional survey assessed all 1,087 patients who were in psychiatric beds provided by a large district health authority. The elderly predominated in all length of stay categories, and a high proportion of them had levels of social and physical incapacity which made it unlikely that they could be cared for other than in residential care. A substantial minority of younger patients with a length of stay between one and two years had levels of incapacity which suggested the need for major treatment, rehabilitation, or training efforts.

Oxidation of hypoxanthines, bearing 8-aryl or 8-pyridyl substituents, by bovine milk xanthine oxidase.

1. Hypoxanthines, bearing at position 8 aryl or pyridyl substituents, are converted by bovine milk xanthine oxidase (xanthine: oxygen oxidoreductase, EC 1.2.

Enzymic oxidation of 3-hydroxyxanthine to 3-hydroxyuric acid.

1. Bovine milk xanthine oxidase (xanthine:oxygen oxidoreductase, EC 1.2.

Influence of 8-substitutes on the oxidation of hypoxanthine and 6-thioxopurine by bovine milk xanthine oxidase.

1. The influence of 8-substituents was studied on the rate of oxidation of hypoxanthine and 6-thioxopurine by bovine milk xanthine oxidase (EC 1.2.

Oxidation of methyl derivatives of pteridin-4-one, lumazine and related pteridines by bovine milk xanthine oxidase.

1. Pteridin-4-ones, methylated at nitrogen or carbon, N-methylated lumazines and related oxopteridines were studied as substrates of a highly purified bovine milk xanthine oxidase (xanthine : oxygen oxidoreductase, EC 1.2.

Oxidation of N-methyl substituted hypoxanthines, xanthines, purine-6,8-diones and the corresponding 6-thioxo derivatives by bovine milk xanthine oxidase.

1. The oxidation of six series of purines (hypoxanthines, xanthines, purine-6,8-diones and the corresponding 6-thioxo derivatives) by a highly purified bovine milk xanthine oxidase (EC 1.2.