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:2017:10.1177/0141076817738499,
author = {Cowling, TE and Laverty, AA and Harris, MJ and Watt, HC and Greaves, F and Majeed, A},
doi = {10.1177/0141076817738499},
journal = {Journal of the Royal Society of Medicine},
pages = {440--451},
title = {Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey},
url = {http://dx.doi.org/10.1177/0141076817738499},
volume = {110},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: To examine associations between the contractand ownership type of general practices and patient experiencein England.Design: Multilevel linear regression analysis of a nationalcross-sectional patient survey (General Practice PatientSurvey).Setting: All general practices in England in 2013–2014(n ¼ 8017).Participants: 903,357 survey respondents aged 18 years orover and registered with a general practice for six monthsor more (34.3% of 2,631,209 questionnaires sent).Main outcome measures: Patient reports of experienceacross five measures: frequency of consulting a preferreddoctor; ability to get a convenient appointment; rating ofdoctor communication skills; ease of contacting the practiceby telephone; and overall experience (measured onfour- or five-level interval scales from 0 to 100). Modelsadjusted for demographic and socioeconomic characteristicsof respondents and general practice populations and arandom intercept for each general practice.Results: Most practices had a centrally negotiated contractwith the UK government (‘General Medical Services’54.6%; 4337/7949). Few practices were limited companieswith locally negotiated ‘Alternative Provider MedicalServices’ contracts (1.2%; 98/7949); these practices providedworse overall experiences than General MedicalServices practices (adjusted mean difference 3.04, 95%CI 4.15 to 1.94). Associations were consistent in directionacross outcomes and largest in magnitude for frequencyof consulting a preferred doctor (12.78, 95% CI15.17 to 10.39). Results were similar for practicesowned by large organisations (defined as having 20 practices)which were uncommon (2.2%; 176/7949).Conclusions: Patients registered to general practicesowned by limited companies, including large organisations,reported worse experiences of their care than otherpatients in 2013–2014.
AU  - Cowling,TE
AU  - Laverty,AA
AU  - Harris,MJ
AU  - Watt,HC
AU  - Greaves,F
AU  - Majeed,A
DO  - 10.1177/0141076817738499
EP  - 451
PY  - 2017///
SN  - 1758-1095
SP  - 440
TI  - Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey
T2  - Journal of the Royal Society of Medicine
UR  - http://dx.doi.org/10.1177/0141076817738499
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000415828000007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/54515
VL  - 110
ER  -
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