The geography of fundholding in southwest England: implications for the evolution of primary care groups.
Using postcode-ED linkage to calculate patient-weighted deprivation indices for 330 general practices in southwest England, this study examines whether the populations served by fundholding and non-fundholding practices varied with respect to socio-economic status. Little evidence is found of systematic socio-economic bias in the uptake of fundholding. However, a distinct spatial pattern to the distribution of fundholding is revealed in this article, urban practices having adopted the scheme more readily than their rural and mixed rural/urban counterparts. As practice-level fundholding is replaced by commissioning at the locality level, such geographical variation is likely to be expressed in the way in which primary care groups evolve.
Asthana
S
S
Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth, UK.
Gibson
A J
AJ
Parsons
E M
EM
D002391:Catchment Area, Health / Q000191:economics / Q000706:statistics & numerical data*; D019352:Censuses; D004739:England; D005194:Family Practice / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008507:Medically Underserved Area; D011204:Poverty Areas; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration; D011610:Psychosocial Deprivation; D012424:Rural Population; D013222:State Medicine / Q000458:organization & administration*; D014505:Urban Population