title: Are there enough GPs in England to detect hypertension and maintain access? A cross-sectional study.
abstract: BACKGROUND
  Fewer patients are recorded by practices as having hypertension than are identified in systematic population surveys. However, as more patients are recorded on practice hypertension registers, mortality from coronary heart disease and stroke declines.
  
  
  OBJECTIVE
  To determine whether the number of GPs per 1000 practice population is associated with the number of patients recorded by practices as having hypertension, and whether patients' reports of being able to get an appointment with a GP are associated with the number of GPs and the number of patients recorded as having hypertension.
  
  
  METHODS
  Cross-sectional study of available data for all general practices in England for 2008 to 2009.
  
  
  METHODS
  A model was developed to describe the hypothesised relationships between population (deprivation, ethnicity, age, poor health) and practice characteristics (list size, number of GPs per 1000 patients, management of hypertension) and the number of patients with hypertension and patient-reported ability to get an appointment fairly quickly. Two regression analyses were undertaken.
  
  
  RESULTS
  Practices recorded only 13.3% of patients as having hypertension. Deprivation, age, poor health, white ethnicity, hypertension management, and the number of GPs per 1000 patients predicted the number of patients recorded with hypertension. Being able to get an appointment fairly quickly was associated with the number of patients recorded with hypertension, age, deprivation, practice list size, and the number of GPs per 1000 patients.
  
  
  CONCLUSIONS
  In order to improve detection of hypertension as part of a strategy to lower mortality from coronary heart disease, the capacity of practices to detect hypertension while maintaining access needs to be improved. Increasing the supply of GPs may be necessary, as well as improvements in efficiency.
authors: NIHR Collaboration for Leadership in Applied Health Research and Care for Leicestershire, Northamptonshire and Rutland, Department of Health Sciences, University of Leicester, Leicester.
authors: M John
authors: MJ
authors: Bankart
authors: Mohammed S
authors: MS
authors: Anwar
authors: Nicola
authors: N
authors: Walker
authors: Arch G
authors: AG
authors: Mainous
authors: Richard
authors: R
authors: Baker
mesh_terms: D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards*; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000592:standards; D058005:General Practitioners / Q000600:supply & distribution*; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012017:Referral and Consultation; D012307:Risk Factors; D012959:Socioeconomic Factors; D000078329:Workforce
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