Associations between ED attendance volumes and practice and population characteristics
| All attendances | Self-referred discharged attendances | GP treatable attendances | No treatment and no follow-up attendances | |
| IRR (95% CI) | IRR (95% CI) | IRR (95% CI) | IRR (95% CI) | |
| Proportion of patients aged 0–4† | 1.444*** (1.316 to 1.584) | 1.501*** (1.258 to 1.791) | 1.390** (1.118 to 1.728) | 1.444** (1.096 to 1.904) |
| Proportion of patients aged 5–15† | 0.966 (0.910 to 1.025) | 1.086 (0.982 to 1.202) | 1.091 (0.956 to 1.247) | 1.242* (1.050 to 1.469) |
| Proportion of patients aged 45–54† | 1.159** (1.061 to 1.266) | 1.089 (0.923 to 1.285) | 1.074 (0.895 to 1.290) | 0.973 (0.782 to 1.211) |
| Proportion of patients aged 55–64† | 0.990 (0.903 to 1.085) | 1.050 (0.893 to 1.236) | 0.966 (0.809 to 1.154) | 1.023 (0.816 to 1.283) |
| Proportion of patients aged 65–74† | 0.979 (0.885 to 1.082) | 0.990 (0.804 to 1.218) | 0.824 (0.627 to 1.082) | 0.831 (0.577 to 1.195) |
| Proportion of patients aged 75–84† | 1.194** (1.059 to 1.346) | 1.126 (0.889 to 1.426) | 1.349 (0.971 to 1.872) | 1.260 (0.862 to 1.844) |
| Proportion of patients aged 85 and over† | 1.396*** (1.207 to 1.615) | 0.946 (0.768 to 1.165) | 0.980 (0.651 to 1.474) | 0.984 (0.663 to 1.462) |
| Income deprivation score† | 1.044*** (1.030 to 1.057) | 1.029* (1.006 to 1.052) | 1.052** (1.021 to 1.084) | 1.045** (1.013 to 1.078) |
| Rural practice | 1.055*** (1.023 to 1.089) | 1.108*** (1.043 to 1.176) | 1.065 (0.996 to 1.139) | 1.070 (0.987 to 1.160) |
| Number of GPs | 0.999 (0.997 to 0.002) | 0.995 (0.990 to 1.000) | 0.998 (0.992 to 1.005) | 0.993 (0.986 to 0.000) |
| Proportion of patients of UK white ethnicity† | 1.016* (1.001 to 1.031) | 1.020 (0.990 to 1.052) | 1.025 (0.990 to 1.062) | 1.062* (1.014 to 1.113) |
| Proportion of patients unemployed† | 1.101*** (1.060 to 1.144) | 1.072*** (1.031 to 1.115) | 1.137*** (1.072 to 1.205) | 1.119*** (1.060 to 1.181) |
| Atrial fibrillation prevalence§ | 0.957* (0.925 to 0.990) | 0.962 (0.898 to .030) | 0.939 (0.873 to 1.011) | 0.945 (0.864 to 1.034) |
| COPD prevalence§ | 1.046*** (1.028 to 1.063) | 1.048** (1.013 to 1.084) | 1.041 (0.999 to 1.085) | 1.047 (0.996 to 1.100) |
| Asthma prevalence§ | 0.988** (0.979 to 0.996) | 0.985* (0.971 to 0.999) | 1.002 (0.982 to 1.023) | 0.985 (0.963 to 1.007) |
| Heart failure prevalence§ | 1.005 (0.960 to 1.053) | 0.971 (0.900 to 1.048) | 0.987 (0.904 to 1.078) | 0.929 (0.835 to 1.034) |
| Coronary heart disease prevalence§ | 1.002 (0.985 to 1.018) | 1.009 (0.975 to 1.045) | 0.984 (0.940 to 1.031) | 1.023 (0.969 to 1.080) |
| Rate of attendance at type 2–4 EDs | 0.928*** (0.906 to 0.950) | 0.834*** (0.793 to 0.876) | 0.824*** (0.775 to 0.876) | 0.775*** (0.720 to 0.834) |
| Distance to nearest ED | 0.983*** (0.979 to 0.986) | 0.970*** 0.962 to 0.977) | 0.974*** (0.966 to 0.982) | 0.975*** (0.965 to 0.985) |
| Responses to GPPS† | 0.931*** (0.911 to 0.952) | 0.933** (0.890 to 0.977) | 0.921** (0.867 to 0.978) | 0.913** (0.853 to 0.977) |
| N | 7521 | 7521 | 7521 | 7521 |
*P< 0.05, **P<0.01, ***P<0.001.
†These variables are scaled so that the IRRs reflect the effects of 10 percentage point differences.
§These variables are scaled so that the IRRs reflect the effects of 1 percentage point difference. Models also include measures of primary care quality, coefficients for which are presented in table 3. They also include indicators for the 13 NHS England local offices in which a general practice is located (NHS England region: London (n=1354), Wessex (n=303), Cheshire and Merseyside (n=379), Cumbria and North East (n=450), Lancashire and Greater Manchester (n=704), Yorkshire and Humber (n=743), Central Midlands (n=550), East (n=533), North Midlands (n=489), West Midlands (n=653), South Central (n=414), South East (n=563) and South West (n=386)).
COPD, chronic obstructive pulmonary disease; ED, emergency department; GP, general practitioner; GPPS, General Practitioner Patient Survey; IRR, incidence rate ratio.