Academic Unit of Primary Health Care, University of Bristol, Bristol, UK.
J Health Serv Res Policy. 2011 Jul;16(3):133-40. doi: 10.1258/jhsrp.2010.010013.
To determine the influence of population, hospital and general practice characteristics on practice admission rates for asthma and chronic obstructive pulmonary disease (COPD) in England.
Cross sectional study using Hospital Episode Statistics (HES), routine population data and primary care data. Admissions for all general practices in England during 2005-06, adjusted for age and sex composition of practice population. Univariable analysis of population, practice and hospital care provision variables, including prevalence and quality data. Significant factors included in multiple regression Poisson model.
Admissions from 8169 practices were included. Risk of admission for each condition increased with deprivation, prevalence and smoking. Admission rates were higher in urban than rural practices. Hospital bed availability and distance to the nearest emergency department were also significantly associated with risk of admission. The associations with practice factors including practice size and quality markers varied across conditions.
Practice population, geographic and hospital supply factors are consistently associated with asthma and COPD admissions. Higher smoking rates among such patients in a practice are associated with higher admission rates. There is little evidence from this study that other modifiable general practice factors are important in influencing admission rates.
确定人口、医院和全科医疗特征对英国哮喘和慢性阻塞性肺疾病（COPD）住院率的影响。
使用医院入院统计数据（HES）、常规人口数据和初级保健数据进行横断面研究。调整了实践人群的年龄和性别构成后，对英格兰所有实践中的所有入院进行了分析。对人口、实践和医院护理提供变量（包括流行率和质量数据）进行单变量分析。将显著因素纳入多变量泊松回归模型。
共纳入 8169 个实践的入院情况。每种疾病的入院风险随贫困程度、流行率和吸烟率的增加而增加。城市实践中的入院率高于农村实践。医院床位的可用性和到最近急诊室的距离与入院风险也有显著关联。与实践因素（包括实践规模和质量指标）的关联因条件而异。
实践人群、地理和医院供应因素与哮喘和 COPD 的入院率始终相关。实践中此类患者的吸烟率较高与较高的入院率相关。本研究几乎没有证据表明其他可改变的全科医疗因素对入院率有重要影响。
