PREDICTING THE WORKLOAD IN URBAN GENERAL-PRACTICE IN THE NETHERLANDS FROM JARMANS INDICATORS OF DEPRIVATION AT PATIENT LEVEL

Study objective - General practitioners (GPs) working in deprived area s supposedly have higher workloads. In the UK, this has led to a highe r payment per patient from deprived areas, based on eight indicators o f deprivation proposed by Jarman. This paper aimed to examine the appl icability of the Jarman index (indicators and attached weights) at pat ient level in an urban GP setting outside the UK. Design - Data on all GP contacts were collected from 5121 residents aged 16 and over by in terview. Setting - Amsterdam, The Netherlands, 1992-93. Main results - Results showed that six out of eight of the Jarman indicators of depr ivation were indeed associated with higher GP contact rates in adults in Amsterdam, though some of them without statistical significance. Th e relative importance of the indicators, however, differed largely fro m Jarman's weights. In particular, people in poor housing, unskilled e arners, and people born in a foreign country had higher contact rates. Furthermore, some indicators were highly inter-related at patient lev el. Conclusions - It is concluded that most of the Jarman indicators c an be used to predict Amsterdam GP workload at patient level, but that their relative weights should be adapted for this aim. The applicabil ity of the Jarman index (indicators and attached weights) in other Eur opean countries requires additional study.