Imperial College London
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Dr Thomas Cowling

Faculty of Medicine, School of Public Health

Honorary Lecturer
 
 
 
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Contact

 

t.cowling Website

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Cowling:2016:10.1136/bmjqs-2016-005233,
author = {Cowling, T and Harris, M and Majeed, F},
doi = {10.1136/bmjqs-2016-005233},
journal = {BMJ Quality & Safety},
pages = {360--371},
title = {Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey},
url = {http://dx.doi.org/10.1136/bmjqs-2016-005233},
volume = {26},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background The UK government plans to extend the opening hours of general practices in England. The ‘extended hours access scheme’ pays practices for providing appointments outside core times (08:00 to 18.30, Monday to Friday) for at least 30min per 1000 registered patients each week.Objective To determine the association between extended hours access scheme participation and patient experience.Methods Retrospective analysis of a national cross-sectional survey completed by questionnaire (General Practice Patient Survey 2013–2014); 903357 survey respondents aged ≥18years old and registered to 8005 general practices formed the study population. Outcome measures were satisfaction with opening hours, experience of making an appointment and overall experience (on five-level interval scales from 0 to 100). Mean differences between scheme participation groups were estimated using multilevel random-effects regression, propensity score matching and instrumental variable analysis.Results Most patients were very (37.2%) or fairly satisfied (42.7%) with the opening hours of their general practices; results were similar for experience of making an appointment and overall experience. Most general practices participated in the extended hours access scheme (73.9%). Mean differences in outcome measures between scheme participants and non-participants were positive but small across estimation methods (mean differences ≤1.79). For example, scheme participation was associated with a 1.25 (95% CI 0.96 to 1.55) increase in satisfaction with opening hours using multilevel regression; this association was slightly greater when patients could not take time off work to see a general practitioner (2.08, 95% CI 1.53 to 2.63).Conclusions Participation in the extended hours access scheme has a limited association with three patient experience measures. This questions expected impacts of current plans to extend opening hours on patient experience.
AU  - Cowling,T
AU  - Harris,M
AU  - Majeed,F
DO  - 10.1136/bmjqs-2016-005233
EP  - 371
PY  - 2016///
SN  - 2044-5423
SP  - 360
TI  - Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey
T2  - BMJ Quality & Safety
UR  - http://dx.doi.org/10.1136/bmjqs-2016-005233
UR  - http://hdl.handle.net/10044/1/34088
VL  - 26
ER  -
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