Recorded quality of primary care for XXXX : an observational study.

@entity1 @entity571 @entity102
BACKGROUND: @entity571 is the most common @entity102 in the UK, with greater prevalence in @entity1 , older @entity1 , and those with poorer socioeconomic status. Effective treatments are available, yet little is known about the quality of primary care for this disabling condition. AIM: To measure the recorded quality of primary care for @entity571 , and assess variations by @entity1 and/or practice characteristics. DESIGN OF STUDY: Retrospective observational study. SETTING: Eighteen general practices in England. METHOD: Records of 320/393 randomly selected @entity1 with @entity571 (response rate 81%) were reviewed. High-quality health care was specified by nine quality indicators. Logistic regression modelling assessed variations in quality by age, sex, deprivation, severity, time since diagnosis, and practice size. RESULTS: There was substantial variation in the recorded achievement of individual indicators (range 5% to 90%). The percentage of eligible @entity1 whose records show that they received care in the form of information provision ranged from 17% to 30%. For regular assessment indicators the range was 27% to 43%, and for treatment indicators the range was 5% to 90%. Recorded achievement of quality indicators was higher in those with more severe @entity571 (odds ratio [OR] 1.38, 95% CI=1.13 to 1.69) and in older @entity1 (OR 1.14, 95% CI=1.02 to 1.28). There were no significant variations by deprivation score. CONCLUSION: This study has demonstrated the feasibility of using existing robust quality indicators to measure the quality of primary care for @entity571 , and has found considerable scope for improvement in the recording of high-quality care. The lack of variation between practices suggests that system-level initiatives may be needed to achieve improvement. One challenge will be to improve care for all, without losing the equitable distribution of care identified.
