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  1. Kevin Mackway Jones, Editor

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Access to primary care and emergency admission rates

It is ‘obvious’ that there is a link between primary, urgent and emergency care— after all, the patients who are seen in all three settings are often the same people. It is less obvious which particular characteristics of the patients, the practices and the hospitals affect the relationship. In a study based in Leicester, England, Bankart and colleagues have examined emergency admission rates—looking at both the known suspects (population deprivation, practice size, age, ethnicity, gender and distance) and the novel measures of access to primary care and practice quality. Their study confirms the previously recognised associations; more interestingly, they found no association between practice quality as reflected in the Quality and Outcomes Framework and emergency admission rates, but they did show an association with patients' reports of access to a named primary care physician. The better the reported access, the lower the admission rate. They argue that even small changes in perceived access can result in a significant change in admission rates (see page 558).

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