Imperial College London
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Dr Kate Honeyford

Faculty of Medicine, School of Public Health

Honorary Research Associate
 
 
 
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Contact

 

k.honeyford

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Honeyford:2013:10.1136/bmjopen-2013-003391,
author = {Honeyford, K and Baker, R and Bankart, MJG and Jones, D},
doi = {10.1136/bmjopen-2013-003391},
journal = {BMJ Open},
title = {Modelling factors in primary care quality improvement: a cross-sectional study of premature CHD mortality},
url = {http://dx.doi.org/10.1136/bmjopen-2013-003391},
volume = {3},
year = {2013}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives: To identify features of primary care qualityimprovement associated with improved health outcomesusing premature coronary heart disease (CHD) mortalityas an example, and to determine impacts of differentmodelling approaches.Design: Cross-sectional study of mortality rates in 229general practices.Setting: General practices from three East Midlandsprimary care trusts.Participants: Patients registered to the practices abovebetween April 2006 and March 2009.Main outcome measures: Numbers of CHD deaths inthose aged under 75 (premature mortality) and at allages in each practice.Results: Population characteristics and markers ofquality of primary care were associated with variations inpremature CHD mortality. Increasing levels ofdeprivation, percentages of practice populations onpractice diabetes registers, white, over 65 and male wereall associated with increasing levels of premature CHDmortality. Control of serum cholesterol levels in thosewith CHD and the percentage of patients recalling accessto their preferred general practitioner were bothassociated with decreased levels of premature CHDmortality. Similar results were found for all-age mortality.A combined measure of quality of primary care for CHDcomprising 12 quality outcomes framework indicatorswas associated with decreases in both all-age andpremature CHD mortality. The selected models suggestthat practices in less deprived areas may have up to 20%lower premature CHD mortality than those with mediandeprivation and that improvement in the CHD care qualityfrom 83% (lower quartile) to 86% (median) could reducepremature CHD mortality by 3.6%. Different modellingapproaches yielded qualitatively similar results.Conclusions: High-quality primary care, includingaspects of access to and continuity of care, detection andmanagement, appears to be associated with reducingCHD mortality. The impact on premature CHD mortality isgreater than on all-age CHD mortality. Determining themost useful measures of quality of p
AU  - Honeyford,K
AU  - Baker,R
AU  - Bankart,MJG
AU  - Jones,D
DO  - 10.1136/bmjopen-2013-003391
PY  - 2013///
SN  - 2044-6055
TI  - Modelling factors in primary care quality improvement: a cross-sectional study of premature CHD mortality
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2013-003391
UR  - http://hdl.handle.net/10044/1/48338
VL  - 3
ER  -
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