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Socioeconomic status and geographical factors associated with active listing in primary care : A cross-sectional population study accounting for multimorbidity, age, sex and primary care

Ranstad, Karin LU ; Midlöv, Patrik LU and Halling, Anders LU (2017) In BMJ Open 7(6).
Abstract

Background: Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. Objective: To explore the relationship between population and practices in a primary care system based on listing. Methods: Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Setting and subjects: Population over 15... (More)

Background: Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. Objective: To explore the relationship between population and practices in a primary care system based on listing. Methods: Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Setting and subjects: Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Main outcome measure: Actively listed in primary care on 31 December 2007. Results: Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike's Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Conclusions: Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care. Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
choice behaviour, comorbidity, geographical factors, Primary health care, socioeconomic factors
in
BMJ Open
volume
7
issue
6
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85020662527
  • wos:000406391200107
ISSN
2044-6055
DOI
10.1136/bmjopen-2016-014984
language
English
LU publication?
yes
id
5cc7a260-b7ce-43d2-95e4-0eb701337bd5
date added to LUP
2017-07-28 12:02:23
date last changed
2017-09-18 11:40:11
@article{5cc7a260-b7ce-43d2-95e4-0eb701337bd5,
  abstract     = {<p>Background: Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. Objective: To explore the relationship between population and practices in a primary care system based on listing. Methods: Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Setting and subjects: Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Main outcome measure: Actively listed in primary care on 31 December 2007. Results: Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike's Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Conclusions: Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care. Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare.</p>},
  articleno    = {e014984},
  author       = {Ranstad, Karin and Midlöv, Patrik and Halling, Anders},
  issn         = {2044-6055},
  keyword      = {choice behaviour,comorbidity,geographical factors,Primary health care,socioeconomic factors},
  language     = {eng},
  number       = {6},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Socioeconomic status and geographical factors associated with active listing in primary care : A cross-sectional population study accounting for multimorbidity, age, sex and primary care},
  url          = {http://dx.doi.org/10.1136/bmjopen-2016-014984},
  volume       = {7},
  year         = {2017},
}