Table 3.
Associations between staff type and population, professional, and system outcomesa
| Outcome | n | Mean (SD) | Estimated effects of one additional FTE on z-score transformation of outcome | |||
|---|---|---|---|---|---|---|
|
| ||||||
| GPs (95% CI) | Nurses (95% CI) | Health professionals (95% CI) | Health associate professionals (95% CI) | |||
| Practice activity | ||||||
| Months since last GP appointment | 6210 | 5.451 (0.660) | −0.043 (−0.057 to −0.028) | 0.105 (0.077 to 0.134) | 0.128 (0.042 to 0.215) | 0.016 (−0.019 to 0.050) |
| Months since last nurse appointment | 6210 | 8.139 (1.237) | 0.047 (0.034 to 0.060) | −0.145 (−0.171 to −0.120) | −0.001 (−0.071 to 0.069) | −0.141 (−0.172 to −0.109) |
|
| ||||||
| GP working conditions | ||||||
| Average hours worked per week by GPs | 1195 | 41.019 (14.458) | −0.021 (−0.048 to 0.005) | 0.047 (−0.014 to 0.108) | 0.060 (−0.133 to 0.254) | 0.010 (−0.055 to 0.074) |
| Percentage of GP work that could be delegated | 1171 | 26.893 (17.649) | −0.037 (−0.064 to −0.011) | 0.086 (0.026 to 0.145) | 0.217 (0.016 to 0.417) | 0.032 (−0.035 to 0.099) |
| GP job satisfaction | 1270 | 4.428 (1.534) | 0.052 (0.025 to 0.080) | 0.007 (−0.052 to 0.066) | 0.112 (−0.085 to 0.310) | −0.068 (−0.135 to −0.002) |
|
| ||||||
| Quality of care | ||||||
| Percentage of QOF points achieved | 6210 | 96.744 (5.596) | 0.058 (0.036 to 0.079) | 0.007 (−0.020 to 0.033) | 0.054 (−0.039 to 0.147) | 0.012 (−0.026 to 0.050) |
| Patient experience with making an appointment | 6210 | 67.451 (14.349) | 0.052 (0.038 to 0.066) | −0.086 (−0.113 to −0.059) | −0.157 (−0.243 to −0.071) | −0.060 (−0.092 to −0.028) |
| Overall patient experience of practice | 6210 | 83.116 (9.635) | 0.080 (0.066 to 0.094) | −0.068 (−0.095 to −0.042) | −0.200 (−0.294 to −0.106) | −0.066 (−0.099 to −0.034) |
|
| ||||||
| Prescribing activity | ||||||
| Items prescribed per thousand patients | 6210 | 19 021.060 (6298.436) | −0.009 (−0.020 to 0.002) | 0.050 (0.033 to 0.067) | −0.062 (−0.138 to 0.013) | 0.026 (0.004 to 0.047) |
| Cost per item prescribed in £ | 6210 | 7.478 (1.295) | 0.021 (0.011 to 0.032) | −0.034 (−0.055 to −0.012) | 0.030 (−0.032 to 0.092) | −0.046 (−0.074 to −0.018) |
| Percentage of narrow-spectrum to total antibiotics | 6210 | 95.913 (1.538) | −0.018 (−0.030 to −0.007) | −0.015 (−0.039 to 0.009) | 0.093 (0.021 to 0.164) | 0.017 (−0.017 to 0.050) |
|
| ||||||
| Hospital activity | ||||||
| ED attendances per thousand patients | 6210 | 238.472 (79.267) | 0.024 (0.013 to 0.035) | 0.020 (−0.001 to 0.041) | 0.029 (−0.033 to 0.092) | 0.023 (−0.005 to 0.051) |
| Outpatient attendances per thousand patients | 6210 | 1471.976 (446.682) | 0.038 (0.027 to 0.050) | 0.009 (−0.014 to 0.032) | 0.084 (0.015 to 0.153) | −0.040 (−0.069 to −0.010) |
| Elective admissions per thousand patients | 6210 | 156.607 (52.245) | 0.032 (0.020 to 0.044) | 0.038 (0.017 to 0.059) | 0.019 (−0.051 to 0.089) | −0.022 (−0.050 to 0.005) |
| Emergency admissions per thousand patients | 6210 | 90.386 (26.908) | 0.041 (0.030 to 0.053) | 0.055 (0.033 to 0.076) | 0.075 (0.012 to 0.137) | −0.029 (−0.057 to −0.002) |
a
Outcome mean and regressions are weighted by the outcome denominator (see Supplementary Appendix S2 for details). Full results from OLS regression model used to derive marginal effects are included in Supplementary Appendix S3. Margin plots showing the effects graphically for a range of staffing percentiles are included in Supplementary Appendix S5. The results of sensitivity checks are available in Supplementary Appendix S6. Full diagnostic indicators for all regression models are in Supplementary Appendix S7. ED = emergency department. FTE = full-time equivalent. OLS = Ordinary Least Squares. QOF = Quality and Outcomes Framework. SD = standard deviation.