Effect of a national programme to introduce named accountable GPs for patients aged 75 and over on continuity of care
Regression discontinuity analysis using primary care data in England
- Purpose of this observational study is to evaluate if the introduction of named accountable GPs to all patients aged 75 and above, introduced in 2014/15, had an effect on continuity of care, in particular on primary care patterns and patient care management.
- Will be carried out in-house by the Health Foundation's Data Analytics team.
- Due to be completed in 2016.
The 2014/15 GP contract in England stipulated that patients aged 75 years or older should be offered a named accountable GP, responsible for ensuring the provision of all appropriate services for their patients. This policy was part of an overall mission to provide more personalised care for patients with long-term health conditions, many of whom are older.
This study will evaluate if designating a named accountable GP had an effect on patient care management, in particular in terms of continuity of care. We will examine changes in primary care utilisation by evaluating the number of GP visits and the UPC index (a measure of the extent to which a patient sees his allocated/regular GP), as well as evaluating the number of referrals, diagnostic tests and health checks over a six month study period.
As the effectiveness of the intervention may depend on factors related to the local context in which the general practices operate, we will also assess whether the effectiveness of the intervention is moderated by general practice characteristics. This moderation analysis may for example identify ways that practices can improve on continuity of care.
Regression discontinuity design is appropriate when eligibility for an intervention changes sharply at a pre-defined threshold, in this case at age 75. As patients have no control over their age, the treatment assignment near the threshold is effectively random. Any discontinuity in the outcome variable at the threshold can therefore be attributed to the treatment.
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