Taylor D H, Leese B
National Primary Care Research & Development Centre, University of Manchester.
J Public Health Med. 1997 Sep;19(3):341-6. doi: 10.1093/oxfordjournals.pubmed.a024641.
The objective of this study was to quantify the rate of partnership change among general practitioners (GPs) in the National Health Service (NHS) in England from 1990 to 1994.
Time series data on English GPs were analysed on 1 October for the years 1990-1994. The main outcome measures include: (1) proportion of GPs practising in an unchanged partnership from 1 October 1990 to 1 October 1994; (2) proportion of partnerships that were unchanged over the study period; (3) the average yearly rate of partnership changes for England and per Family Health Service Authority (FHSA), calculated using both the individual GP and the practice as the unit of analysis.
A total of 6532 (27.1 per cent) of the 24,107 unrestricted GPs practising full time on 1 October 1990 were still practising in the identical partnership on 1 October 1994; 3539 (35.7 per cent) of the 9918 practices in England were unchanged over the same period. The average yearly partnership change rate for all England was 23.1 per cent when calculated using the individual GP as the unit of analysis, and 23.4 per cent when calculated using the practice as the unit of analysis. There is threefold variation found in the average yearly partnership change rate by FHSA, with similar rank ordering of health authorities when using either the individual GP or practice as unit of analysis.
Changes in partnerships are commonplace. The possible influence of such changes on primary care in the NHS should be further investigated.
本研究的目的是量化1990年至1994年英格兰国民健康服务体系（NHS）中全科医生（GP）的合伙关系变化率。
对1990 - 1994年每年10月1日的英格兰全科医生时间序列数据进行分析。主要结局指标包括：（1）1990年10月1日至1994年10月1日在未改变的合伙关系中执业的全科医生比例；（2）在研究期间未改变的合伙关系比例；（3）以个体全科医生和诊所作为分析单位，计算英格兰及每个家庭健康服务管理局（FHSA）的合伙关系年平均变化率。
1990年10月1日全职执业的24,107名无限制全科医生中，共有6532名（27.1%）在1994年10月1日仍在同一合伙关系中执业；同期英格兰9918家诊所中有3539家（35.7%）未发生变化。以个体全科医生作为分析单位时，全英格兰的合伙关系年平均变化率为23.1%，以诊所作为分析单位时为23.4%。按家庭健康服务管理局计算，合伙关系年平均变化率存在三倍差异，无论以个体全科医生还是诊所作为分析单位，各健康管理局的排名顺序相似。
合伙关系的变化很常见。此类变化对国民健康服务体系初级医疗的可能影响应进一步研究。
