Thousands of CHD patients ‘missing’ from registers in deprived areas

Up to 35 per cent of CHD cases are ‘missing’ from practice disease registers in the most deprived PCTs, research findings suggest.

Areas of high deprivation were more likely to report low CHD prevalence despite high mortality rates, researchers reported at the annual scientific meeting of the Society for Academic Primary Care in London this month.

The study findings also go against suggestions that areas of high deprivation would have higher rates of exception reporting than those of low deprivation.

For CHD at least, there was no significant difference between the two groups, with exception reporting averaging at 7.5 per cent.

Quality framework data from computing systems of 8,124 GP practices in England for 2004/5 were analysed for the latest study, alongside information from the 2001 UK consensus, CHD mortality data and information on GP practice characteristics.

Although reported CHD prevalence strongly correlated with mortality rates for PCTs, the more deprived a population, the more likely reported prevalence was to deviate from that modelled.

In the worse cases, PCTs up to 3,300 expected CHD cases were missing from GP registers.

Lead researcher Dr Tim Doran, from the National Primary Care Research and Development Centre in Manchester, says he is unwilling to name and shame the PCTs until the finding is clarified.

‘Your first suspicion is that people in high deprivation areas are not being registered, but the thing is, in these areas some people are dying quite young.’

As age of death is incorporated into mortality rate calculations, it may be that practices are registering most CHD patients, but as they die young the mortality rate seems especially high, he said.

‘It doesn’t look like the number of practices missing patients is any greater than the nationwide undercount.

‘If we did screen people for CHD, we would see that undercount come down.’

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