GP Register list inflation

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GP Register list inflation
David Lawrence Public Health Consultant Brent
PCT Hon Senior Lecturer London School of
Hygiene and Tropical Medicine
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What is list inflation?
Definition 1 - The extent to which the patient
register provides a higher population count than
the Registrar Generals population estimates1
Definition 2 - The difference between the number
of registered patients listed on a GP register
and the number on register actually existing
1 Using patient registers to estimate internal
migration. Technical guidance notes, Migration
statistics unit, ONS, August 2002
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Why list inflation occurs
When registered patients who leave the practice,
move away or die, are not removed from the list

• Removal from list only happens when
• The person registers with another general
  practice within the NHS
• The general practice or other agency
  identifies and removes such a person

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inflation is greater when

• High list turnover from migration
• Community is unstable
• Financial disincentive to remove patients

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Uses of GP lists

• Paying GPs
• General practice population denominators for
  estimating

• Screening performance
• Quality Outcomes Framework (QOF) prevalence
• Practice-based commissioning
• Primary care business planning
• Demand management
• Health inequalities within Brent

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Health care use variation
Reid - Admission rates BMJ 1999 319 98
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List Inflation by Government Office Region 1999
Using patient registers to estimate internal
migration. Technical guidance notes, Migration
statistics unit, ONS, August 2002
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List Inflation within Regions 1999
Using patient registers to estimate internal
migration. Technical guidance notes, Migration
statistics unit, ONS, August 2002
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Local Authorities 1999Ten with highest list
inflation
Using patient registers to estimate internal
migration. Technical guidance notes, Migration
statistics unit, ONS, August 2002
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Local Authorities 1999Ten with lowest list
inflation
Using patient registers to estimate internal
migration. Technical guidance notes, Migration
statistics unit, ONS, August 2002
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List inflation within a PCT 2006
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List Inflation within Brent 2007
Data from Brent PCT analysis from GP Register data
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List Inflation within Brent
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List Inflation within Brent