High-Quality Primary Care Tied to Improved Health Outcomes

Association between high-quality care, improved CHD outcomes strongest in deprived areas
By Beth Gilbert
HealthDay Reporter

FRIDAY, Sept. 10 (HealthDay News) -- Higher-quality coronary heart disease (CHD) care among general practices in the United Kingdom is associated with lower CHD admissions and mortality rates, with the association strongest among practices serving populations with high levels of deprivation, according to a study in the October issue of the Journal of Epidemiology and Community Health.

In a cross-sectional study, Tara Kiran, Ph.D., of the Li Ka Shing Knowledge Institute of St Michael's Hospital in Toronto, and colleagues evaluated the association between quality of cardiovascular care and CHD outcomes in 1,531 general practices in London using 2006 to 2007 data from the Quality and Outcomes Framework, a financial incentive scheme for general practitioners in the United Kingdom.

The investigators found that better CHD outcomes, including fewer CHD admissions and lower CHD mortality rates, occurred in practices with higher CHD quality achievement scores. Specifically, every one-point increase in the CHD quality achievement score was associated with 4.28 fewer admissions per 100,000 for general practices that served highly deprived populations and 2.11 fewer admissions per 100,000 for those that served populations with average levels of deprivation. No similar association was found for practices serving affluent populations. The researchers found a similar deprivation-dependent gradient between quality achievement and CHD mortality.

"High-quality primary care is associated with improved health outcomes," the authors write. "This association is strongest in deprived areas, suggesting that high-quality primary care may play an important role in reducing health inequalities."

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