Data from: Population characteristics, mechanisms of primary care and premature mortality in England: a cross-sectional study

Objectives. Health systems with strong primary care tend to have better
population outcomes, but in many countries demand for care is growing. We
sought to identify mechanisms of primary care that influence premature
mortality. Design. We developed a conceptual model of the mechanisms by
which primary care influences premature mortality, and undertook a
cross-sectional study in which population and primary care variables
reflecting the model were used to explain variations in mortality under
aged 75 years. The premature standardised mortality ratios (SMRs) for each
practice, available from the Department of Health, had been calculated
from numbers of deaths in the five years 2006-10. A regression model was
undertaken with explanatory variables for the year 2009/10, and repeated
to check stability using data for 2008/09 and 2010/11. Setting: All
general practices in England were eligible for inclusion, and of the total
of 8290, complete data were available for 7858. Results. Population
variables, particularly deprivation, were the most powerful predictors of
premature mortality, but the mechanisms of primary care depicted in our
model also affected mortality. The number of GPs/1000 population and
detection of hypertension were negatively associated with mortality. In
less deprived practices, continuity of care was also negatively associated
with mortality. Conclusions. Greater supply of primary care is associated
with lower premature mortality even in a health system that has strong
primary care (England). Health systems need to sustain the capacity of
primary care to deliver effective care, and should assist primary care
providers in identifying and meeting the needs of socio-economically
deprived groups.