Harcourt S E, Edwards D E, Fleming D M, Smith R L, Smith G E
Health Protection Agency West Midlands, Regional Surveillance Unit, 2nd Floor, Lincoln House, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS.
J Public Health (Oxf). 2004 Mar;26(1):88-94. doi: 10.1093/pubmed/fdh111.
The Royal College of General Practitioners Weekly Returns Service (WRS) is a network of sentinel general practices providing weekly data on illnesses diagnosed in general practice across England and Wales. The WRS contributes to the surveillance of infectious disease, most notably influenza. We use Geographical Information Systems (GIS) techniques to establish whether the practice populations of the current WRS are representative of the general population.
This study compares the practice population with the general population using the Department of the Environment, Transport and Regions (DETR) Indices of Deprivation 2000 scores for English wards.
Comparisons at the national level reveal that the WRS population is less deprived than the general population. At a supra-regional level the WRS practice population shows the same North-South differences as the national population, but the proportions of patients in the more deprived and least deprived wards are more exaggerated in the WRS population. A supplementary analysis reveals that the WRS has no patients in the most deprived wards of London.
The differences have implications for the future recruitment of practices to the WRS. Previous studies have demonstrated the effect of socio-economic deprivation on GP consultation rates. To ensure that the consultation rates reported by the WRS will better reflect consulting patterns in the general population the WRS will need to recruit practices with patients in the most deprived areas of the South and less deprived areas in the North of England. This study demonstrates the value of GIS in the establishment of surveillance systems.
皇家全科医师学院每周回报服务(WRS)是一个由哨点全科诊所组成的网络,提供关于英格兰和威尔士全科诊所诊断疾病的每周数据。WRS有助于传染病监测,尤其是流感。我们使用地理信息系统(GIS)技术来确定当前WRS的诊所人群是否代表一般人群。
本研究使用环境、运输和区域部(DETR)2000年英格兰病房贫困指数得分,将诊所人群与一般人群进行比较。
全国层面的比较显示,WRS人群的贫困程度低于一般人群。在超区域层面,WRS诊所人群与全国人群呈现相同的南北差异,但在贫困程度较高和较低的病房中,WRS人群患者的比例差异更为明显。补充分析显示,WRS在伦敦最贫困的病房中没有患者。
这些差异对未来WRS诊所的招募有影响。先前的研究已经证明了社会经济剥夺对全科医生诊疗率的影响。为确保WRS报告的诊疗率能更好地反映一般人群的诊疗模式,WRS需要招募在英格兰南部最贫困地区和北部贫困程度较低地区有患者的诊所。本研究证明了GIS在建立监测系统中的价值。