At 08:23 5/9/96 GMT, Dr Adrian Midgley wrote:
>
>-In practical terms the manouvre demanded of GPs would be that taking the
>list of every patient of their practice, (or perhaps done by individual GP)
>they rank all these patients in order from most urgent to least urgent.
>Note that this means including medical and surgical, orthopaedic and
>gastrointestinal, rheumatological and dermatological etc all in the SAME
>list.
>
>-The assumption I have made is that on average, the patient who comes 37%
>down your list in a practice of 6 GPs will be as urgent as the patient who
>comes 37% down my list in my practice with one GP.
>-I specifically reject reporting them in order as number 1 - 2 - 97 as the
>different sizes of practice and list and the random variations in numbers
>of patients on the waiting list would render this unworkable.
>
>-I would welcome a statistical view on that - I think it is a proper
>assumption.
This would only hold if the demographic profile of every practice was similar.
eg. practice X covers a new housing estate which will (may) have a large
number of healthy youngish adults but practice Y covers an inner city area.
The people in the first percentile of X's list are unlikely to be as
'absolutely' urgent as those in Y's first percentile.
or to re-phrase - X ranks an in-growing toenail at 52%, Y would rank it at
70% simply because he/she has other more serious things to deal with. Should
the toenail consultant then put X's patients ahead of Y's?
I suspect a similar point applies to the morbidity rates for each practice.
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Andrew Capey [log in to unmask]
Corporate Data Manager
Royal Brompton Hospital Tel: 0171 351 8726
Sydney Street, London SW3 6NP, UK Fax: 0171 351 8743
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