What do hospital admission rates say about primary care?

BMJ 1999;319:67-68 ( 10 July )

Editorials

What do hospital admission rates say about primary care?

Their limitations suggest the need for more appropriate measures

General practice pp 94 , 98

The first 150 words of the full text of this article appear below.

In its white paper on the English NHS the government has emphasised the need for an accountability framework against whichto measure its objectives. A consultation document has suggestedthat health authorities should use performance indicators suchas hospital admission rates as a measure of the quality of primarycare.¹ Yet two papers in this week's BMJ cast further doubton hospital admission rates as a good measure of general practiceperformance.

In the United States high hospital admission rates for chronic diseases like asthma, hypertension, congestive cardiac failure,chronic obstructive airways disease, and diabetes have been associatedwith lack of access to a primary care physician.² In the UnitedKingdom substantial variation exists in admission rates amongboth health authorities³and general practices.⁴ Variation in general practitioner referralrates is correlated with subsequent variation in elective admissions.⁵Given the continuing rise of both elective and emergency admissionsin the . . . [Full text of this article]

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