Do single handed practices offer poorer care? Cross sectional survey of processes and outcomes.
OBJECTIVE
To determine whether there are important differences in performance between group practices and singlehanded general practitioners and the extent to which any differences are explained by practice characteristics such as deprivation.


METHODS
Cross sectional survey.


METHODS
206 singlehanded practices and 606 partnerships in Trent region, United Kingdom.


METHODS
Comparison of process and outcome measures derived from routinely collected data on hospital admissions and target payments for singlehanded practices and partnerships. Multivariate analysis was used to adjust for the confounding effects of general practice characteristics-deprivation (Townsend score), percentage of Asian residents, percentage of black residents, proportion of men over 75 years, proportion of women over 75 years, rurality, presence of a female general practitioner, and vocational training status.


RESULTS
Differences in achievement of immunisation and cytology targets apparent on univariate analysis were not seen after adjustment for other general practice characteristics. Similarly, significant differences (>15%; P<0.01) for three types of hospital admission seen on univariate analysis were not present after adjustment for other practice characteristics.


CONCLUSIONS
This study provides no evidence that singlehanded general practitioners are underperforming clinically. Our results offer insight into the structural difference between the two types of practice and underline the importance of the effect of other practice characteristics on process and outcome measures.
Hippisley-Cox
J
J
Division of General Practice, University of Nottingham, Nottingham NG7 2RD. julia.hippisley-cox@nottingham.ac.uk
Pringle
M
M
Coupland
C
C
Hammersley
V
V
Wilson
A
A
D003430:Cross-Sectional Studies; D004739:England; D005194:Family Practice / Q000592:standards*; D005260:Female; D006123:Group Practice / Q000592:standards*; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011331:Private Practice / Q000592:standards*; D012044:Regression Analysis