BMJ 1999;319:26-28 ( 3 July )

General Practice

Socioeconomic differences in general practice consultation rates in patients aged 65 and over: prospective cohort study

Rosie McNiece, lecturer in statistics, a Azeem Majeed, medical epidemiologist. b

a School of Mathematics, Kingston University, Kingston KT2 6SB, b Office for National Statistics, London SW1V 2QQ

Correspondence to: Dr Majeed azeem.majeed{at}ons.gov.uk

Objective: To examine socioeconomic differences in general practice consultation rates among patients aged 65 years and over.
Design: Secondary analysis of data from the fourth national survey of morbidity in general practice.
Setting: 60 general practices in England and Wales.
Subjects: 71 984 people aged 65 years and over.
Main outcome measures: Annual contact rates and home visiting rates with general practitioners and practice nurses.
Results: Social class differences in contact rates were greatest in 65-74 year olds, with rates 23% higher in patients from social class V than in class I (4.82 v 3.93 per person). In 75-84 year olds there was no clear association between social class and contact rates, and in people aged >= 85 years contact rates were highest in patients from class I. Home visiting rates were twice as high in patients from class V as in patients from class I (1.38 v 0.66 per person). Contact rates were 17% higher in people living in communal establishments and 8% higher in those living alone than in those living with others but not in a communal establishment. 66% of contacts with patients in communal establishments and 26% of those with patients living alone were in patients' homes compared with 18% with those living in standard accommodation. These differences persisted after adjustment in a generalised linear model.
Conclusions: Elderly people show socioeconomic differences in consultation rates. The extra workload generated by elderly people living alone and in communal establishments suggests additional payments to general practitioners are needed.


Key messages

  • Little is known about the effect of socioeconomic status on use of general practice services by elderly people

  • In this national study contact rates were 14% higher and home visiting rates 109% higher in elderly patients from social class V than in patients from class I

  • Contact rates were 17% higher in elderly people living in communal establishments and 8% higher in elderly people living alone than in those living in standard accommodation

  • 66% of contacts with patients in communal establishments and 26% with those living alone were in patients' homes compared with 18% of contacts with those in standard accommodation




© BMJ 1999
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Social class affects old people's use of general practice
BMJ 1999 319: 0. [Full Text]

This article has been cited by other articles:

  • Foster, A., Jordan, K., Croft, P. (2006). Is frequent attendance in primary care disease-specific?. Fam Pract 23: 444-452 [Abstract] [Full text]  
  • Chaix, B., Veugelers, P. J., Boelle, P.-Y., Chauvin, P. (2005). Access to general practitioner services: the disabled elderly lag behind in underserved areas. Eur J Public Health 15: 282-287 [Abstract] [Full text]  
  • Kadam, U T, Jordan, K, Croft, P R (2004). Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Ann Rheum Dis 63: 408-414 [Abstract] [Full text]  
  • Lord, J (2003). Future of primary healthcare education: current problems and potential solutions. Postgrad. Med. J. 79: 553-560 [Abstract] [Full text]  
  • Weaver, N, Williams, J L, Weightman, A L, Kitcher, H N, Temple, J M F, Jones, P, Palmer, S (2002). Taking STOX: developing a cross disciplinary methodology for systematic reviews of research on the built environment and the health of the public. J. Epidemiol. Community Health 56: 48-55 [Abstract] [Full text]  
  • Grundy, E, Holt, G (2001). The socioeconomic status of older adults: How should we measure it in studies of health inequalities?. J. Epidemiol. Community Health 55: 895-904 [Abstract] [Full text]  
  • Reijneveld, S. A, Stronks, K. (2001). The validity of self-reported use of health care across socioeconomic strata: a comparison of survey and registration data. Int J Epidemiol 30: 1407-1414 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Socio-demographic factors and financial incentives affect influenza vaccination coverage in elderly
Fabio Barbone
bmj.com, 19 Jul 1999 [Full text]
Re: Socio-demographic factors and financial incentives affect influenza vaccination coverage in elderly
Simon Giorgio
bmj.com, 4 Nov 2003 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ