Table 3

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 attendancesEmergency admissionsFrequency seeing preferred doctorSame-day appointmentOverall satisfaction
CoefficientP valueCoefficientP valueCoefficientP valueCoefficientP valueCoefficientP value
Persistent high turnover1.80 (1.55 to 2.05)<0.0010.11 (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 1ReferenceReferenceReferenceReferenceReference
IMD 20.92 (0.48 to 1.36)<0.0010.30 (0.20 to 0.40)<0.001−0.14 (−0.89 to 0.61)0.7180.59 (−0.18 to 1.35)0.133−0.68 (−1.08 to –0.28)0.001
IMD 32.36 (1.90 to 2.81)<0.0010.65 (0.55 to 0.76)<0.001−1.78 (−2.57 to –1.00)<0.0010.85 (0.07 to 1.63)0.033−1.95 (−2.36 to –1.53)<0.001
IMD 44.86 (4.39 to 5.33)<0.0011.06 (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 57.94 (7.45 to 8.44)<0.0011.71 (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 10.17 (−0.17 to 0.52)0.320.16 (0.08 to 0.23)<0.00110.71 (10.14 to 11.29)<0.0011.96 (1.24 to 2.68)<0.0010.22 (−0.09 to 0.53)0.160
List size 20.27 (−0.02 to 0.56)0.060.06 (0.01 to 0.12)0.0334.74 (4.27 to 5.20)<0.001−0.35 (−1.04 to 0.33)0.3110.26 (0.01 to 0.52)0.044
List size 3ReferenceReferenceReferenceReferenceReference
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)<0.0010.37 (−0.31 to 1.06)0.287−0.2 (−0.46 to 0.05)0.119
List size 50.35 (0.00 to 0.70)0.050.11 (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
LondonReferenceReferenceReferenceReferenceReference
Central Midlands−4.92 (−5.62 to –4.21)<0.0010.96 (0.80 to 1.13)<0.0016.77 (5.53 to 8.00)<0.00110.70 (9.59 to 11.81)<0.0013.63 (2.99 to 4.27)<0.001
East Midlands−4.32 (−5.03 to –3.61)<0.0010.64 (0.47 to 0.81)<0.00110.49 (9.24 to 11.75)<0.00110.91 (9.77 to 12.04)<0.0014.96 (4.32 to 5.61)<0.001
North Midlands−4.26 (−4.99 to –3.53)<0.0011.49 (1.32 to 1.67)<0.00110.98 (9.70 to 12.26)<0.00110.18 (9.02 to 11.35)<0.0016.21 (5.55 to 6.87)<0.001
West Midlands0.40 (−0.26 to 1.06)0.2311.30 (1.15 to 1.46)<0.0017.51 (6.35 to 8.67)<0.0017.46 (6.41 to 8.52)<0.0013.78 (3.19 to 4.38)<0.001
Cheshire and Merseyside−1.14 (−1.94 to –0.34)0.0053.20 (3.00 to 3.39)<0.00110.76 (9.35 to 12.16)<0.00112.54 (11.25 to 13.82)<0.0017.98 (7.25 to 8.71)<0.001
Cumbria and North East−3.74 (−4.53 to –2.95)<0.0012.56 (2.38 to 2.75)<0.00114.53 (13.14 to 15.92)<0.0017.52 (6.25 to 8.79)<0.0018.84 (8.12 to 9.56)<0.001
Greater Manchester3.07 (2.34 to 3.80)<0.0012.33 (2.16 to 2.51)<0.0018.73 (7.44 to 10.01)<0.0013.29 (2.14 to 4.45)<0.0015.83 (5.16 to 6.49)<0.001
Lancashire and South Cumbria−6.17 (−7.11 to –5.24)<0.0012.17 (1.95 to 2.40)<0.00112.88 (11.22 to 14.54)<0.0018.47 (6.98 to 9.96)<0.0016.53 (5.68 to 7.38)<0.001
Yorkshire and Humber0.84 (0.20 to 1.47)0.0101.73 (1.58 to 1.88)<0.0019.75 (8.63 to 10.87)<0.0019.22 (8.20 to 10.24)<0.0016.08 (5.51 to 6.66)<0.001
South Central−6.29 (−7.06 to –5.51)<0.0010.48 (0.30 to 0.67)<0.00111.07 (9.71 to 12.44)<0.0016.47 (5.23 to 7.7)<0.0015.92 (5.22 to 6.63)<0.001
South East−2.40 (−3.09 to –1.71)<0.0011.09 (0.93 to 1.26)<0.00110.46 (9.25 to 11.67)<0.00110.42 (9.33 to 11.52)<0.0014.42 (3.79 to 5.04)<0.001
South West−5.33 (−6.13 to –4.53)<0.0011.05 (0.86 to 1.24)<0.00115.20 (13.80 to, 16.60)<0.00114.30 (13.02 to 15.58)<0.0018.49 (7.76 to 9.21)<0.001
Wessex−7.28 (−8.15 to –6.42)<0.0011.51 (1.31 to 1.72)<0.00115.79 (14.27 to 17.30)<0.0018.78 (7.40 to 10.16)<0.0017.69 (6.91 to 8.48)<0.001
QOF prevalence of serious conditions (%)0.16 (0.15 to 0.18)<0.0010.09 (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)<0.0014.81 (3.98 to 5.64)<0.0011.61 (0.84 to 2.38)0.3942.91 (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.