Cross sectional study of primary care groups in London: association of measures of socioeconomic and health status with hospital admission rates

Objectives To calculate socioeconomic and health status measures for the pr imary care groups in London and to examine the association between these me asures and hospital admission rates. Design Cross sectional study. Setting 66 primary care groups in London, total list size 8.0 million peopl e. Main outcome measures Elective and emergency standardised hospital admissio n ratios; standardised admission rates for diabetes and asthma. Results Standardised hospital admission ratios varied from 74 to 116 for to tal admissions and from 50 to 124 for emergency admissions. Directly standa rdised admission rates for asthma varied from 152 to 801 per 100 000 (mean 364) and for diabetes from 235 to 1034 per 100 000 (mean 538). There were l arge differences in the mortality, socioeconomic, and general practice char acteristics of the primary care groups. Hospital admission rates were signi ficantly correlated with many of the measures of chronic illness and depriv ation. The strongest correlations were with disability living allowance (R = 0.64 for total admissions and R = 0.62 for emergency admissions, P <0.000 1). Practice characteristics were less strongly associated with hospital ad mission rates. Conclusions It is feasible to produce a range of socioeconomic, health stat us, and practice measures for primary care groups for use in needs assessme nt and in planning and monitoring health services. These measures show that primary care groups have highly variable patient and practice characterist ics and that hospital admission rates are associated with chronic illness a nd deprivation. These variations will need to be taken into account when as sessing performance.