Multivariable analysis of the association between ‘persistent high turnover’ and outcomes (emergency attendances, emergency admissions, proportion of patients seeing their preferred doctor, proportion of patients getting an appointment on the same day or proportion of patients overall satisfied with the practice)
| Emergency attendances | Emergency admissions | Frequency seeing preferred doctor | Same-day appointment | Overall satisfaction | ||||||
| Coefficient | P value | Coefficient | P value | Coefficient | P value | Coefficient | P value | Coefficient | P value | |
| Persistent high turnover | 1.80 (1.55 to 2.05) | <0.001 | 0.11 (0.06 to 0.16) | <0.001 | −5.25 (−5.64 to –4.86) | <0.001 | −10.61 (−11.40 to –9.81) | <0.001 | −1.34 (−1.56 to –1.12) | <0.001 |
| IMD 1 | Reference | Reference | Reference | Reference | Reference | |||||
| IMD 2 | 0.92 (0.48 to 1.36) | <0.001 | 0.30 (0.20 to 0.40) | <0.001 | −0.14 (−0.89 to 0.61) | 0.718 | 0.59 (−0.18 to 1.35) | 0.133 | −0.68 (−1.08 to –0.28) | 0.001 |
| IMD 3 | 2.36 (1.90 to 2.81) | <0.001 | 0.65 (0.55 to 0.76) | <0.001 | −1.78 (−2.57 to –1.00) | <0.001 | 0.85 (0.07 to 1.63) | 0.033 | −1.95 (−2.36 to –1.53) | <0.001 |
| IMD 4 | 4.86 (4.39 to 5.33) | <0.001 | 1.06 (0.95 to 1.17) | <0.001 | −3.81 (−4.61 to –3.00) | <0.001 | −0.01 (−0.82 to 0.79) | 0.973 | −2.97 (−3.39 to –2.55) | <0.001 |
| IMD 5 | 7.94 (7.45 to 8.44) | <0.001 | 1.71 (1.60 to 1.83) | <0.001 | −6.12 (−6.97 to –5.27) | <0.001 | −0.16 (−0.99 to 0.68) | 0.712 | −4.35 (−4.79 to –3.9) | <0.001 |
| List size 1 | 0.17 (−0.17 to 0.52) | 0.32 | 0.16 (0.08 to 0.23) | <0.001 | 10.71 (10.14 to 11.29) | <0.001 | 1.96 (1.24 to 2.68) | <0.001 | 0.22 (−0.09 to 0.53) | 0.160 |
| List size 2 | 0.27 (−0.02 to 0.56) | 0.06 | 0.06 (0.01 to 0.12) | 0.033 | 4.74 (4.27 to 5.20) | <0.001 | −0.35 (−1.04 to 0.33) | 0.311 | 0.26 (0.01 to 0.52) | 0.044 |
| List size 3 | Reference | Reference | Reference | Reference | Reference | |||||
| List size 4 | −0.35 (−0.64 to –0.06) | 0.02 | −0.05 (−0.11 to 0.01) | 0.113 | −4.25 (−4.71 to –3.78) | <0.001 | 0.37 (−0.31 to 1.06) | 0.287 | −0.2 (−0.46 to 0.05) | 0.119 |
| List size 5 | 0.35 (0.00 to 0.70) | 0.05 | 0.11 (0.03 to 0.18) | 0.004 | −9.14 (−9.71 to –8.57) | <0.001 | −2.16 (−2.9 to –1.43) | <0.001 | −0.83 (−1.14 to –0.52) | <0.001 |
| London | Reference | Reference | Reference | Reference | Reference | |||||
| Central Midlands | −4.92 (−5.62 to –4.21) | <0.001 | 0.96 (0.80 to 1.13) | <0.001 | 6.77 (5.53 to 8.00) | <0.001 | 10.70 (9.59 to 11.81) | <0.001 | 3.63 (2.99 to 4.27) | <0.001 |
| East Midlands | −4.32 (−5.03 to –3.61) | <0.001 | 0.64 (0.47 to 0.81) | <0.001 | 10.49 (9.24 to 11.75) | <0.001 | 10.91 (9.77 to 12.04) | <0.001 | 4.96 (4.32 to 5.61) | <0.001 |
| North Midlands | −4.26 (−4.99 to –3.53) | <0.001 | 1.49 (1.32 to 1.67) | <0.001 | 10.98 (9.70 to 12.26) | <0.001 | 10.18 (9.02 to 11.35) | <0.001 | 6.21 (5.55 to 6.87) | <0.001 |
| West Midlands | 0.40 (−0.26 to 1.06) | 0.231 | 1.30 (1.15 to 1.46) | <0.001 | 7.51 (6.35 to 8.67) | <0.001 | 7.46 (6.41 to 8.52) | <0.001 | 3.78 (3.19 to 4.38) | <0.001 |
| Cheshire and Merseyside | −1.14 (−1.94 to –0.34) | 0.005 | 3.20 (3.00 to 3.39) | <0.001 | 10.76 (9.35 to 12.16) | <0.001 | 12.54 (11.25 to 13.82) | <0.001 | 7.98 (7.25 to 8.71) | <0.001 |
| Cumbria and North East | −3.74 (−4.53 to –2.95) | <0.001 | 2.56 (2.38 to 2.75) | <0.001 | 14.53 (13.14 to 15.92) | <0.001 | 7.52 (6.25 to 8.79) | <0.001 | 8.84 (8.12 to 9.56) | <0.001 |
| Greater Manchester | 3.07 (2.34 to 3.80) | <0.001 | 2.33 (2.16 to 2.51) | <0.001 | 8.73 (7.44 to 10.01) | <0.001 | 3.29 (2.14 to 4.45) | <0.001 | 5.83 (5.16 to 6.49) | <0.001 |
| Lancashire and South Cumbria | −6.17 (−7.11 to –5.24) | <0.001 | 2.17 (1.95 to 2.40) | <0.001 | 12.88 (11.22 to 14.54) | <0.001 | 8.47 (6.98 to 9.96) | <0.001 | 6.53 (5.68 to 7.38) | <0.001 |
| Yorkshire and Humber | 0.84 (0.20 to 1.47) | 0.010 | 1.73 (1.58 to 1.88) | <0.001 | 9.75 (8.63 to 10.87) | <0.001 | 9.22 (8.20 to 10.24) | <0.001 | 6.08 (5.51 to 6.66) | <0.001 |
| South Central | −6.29 (−7.06 to –5.51) | <0.001 | 0.48 (0.30 to 0.67) | <0.001 | 11.07 (9.71 to 12.44) | <0.001 | 6.47 (5.23 to 7.7) | <0.001 | 5.92 (5.22 to 6.63) | <0.001 |
| South East | −2.40 (−3.09 to –1.71) | <0.001 | 1.09 (0.93 to 1.26) | <0.001 | 10.46 (9.25 to 11.67) | <0.001 | 10.42 (9.33 to 11.52) | <0.001 | 4.42 (3.79 to 5.04) | <0.001 |
| South West | −5.33 (−6.13 to –4.53) | <0.001 | 1.05 (0.86 to 1.24) | <0.001 | 15.20 (13.80 to, 16.60) | <0.001 | 14.30 (13.02 to 15.58) | <0.001 | 8.49 (7.76 to 9.21) | <0.001 |
| Wessex | −7.28 (−8.15 to –6.42) | <0.001 | 1.51 (1.31 to 1.72) | <0.001 | 15.79 (14.27 to 17.30) | <0.001 | 8.78 (7.40 to 10.16) | <0.001 | 7.69 (6.91 to 8.48) | <0.001 |
| QOF prevalence of serious conditions (%) | 0.16 (0.15 to 0.18) | <0.001 | 0.09 (0.09 to 0.10) | <0.001 | −0.41 (−0.43 to –0.38) | <0.001 | −0.40 (−0.43 to –0.37) | <0.001 | −0.03 (−0.05 to –0.02) | <0.001 |
| Rurality | −3.78 (−4.25 to –3.30) | <0.001 | −0.72 (−0.83 to –0.61) | <0.001 | 4.81 (3.98 to 5.64) | <0.001 | 1.61 (0.84 to 2.38) | 0.394 | 2.91 (2.48 to 3.34) | <0.001 |
Note: mean and SD for each list size. List size 1: 2528 (592); list size 2: 4493 (565); list size 3: 6532 (649); list size 4: 9119 (866); list size 5: 14 291 (4362). The variable region represents the 14 NHS regions in England.
IMD, Index of Multiple Deprivation; QOF, quality and outcomes framework.