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Disenrollment from general practitioners among chronic patients: a register-based longitudinal study of Norwegian claims data

Overview of attention for article published in BMC Family Practice, December 2016
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Title
Disenrollment from general practitioners among chronic patients: a register-based longitudinal study of Norwegian claims data
Published in
BMC Family Practice, December 2016
DOI 10.1186/s12875-016-0571-3
Pubmed ID
Authors

Anastasia Mokienko, Knut Reidar Wangen

Abstract

Norwegian general practitioners (GPs) consult on a variety of conditions with a mix of patient types. Patients with chronic diseases benefit from appropriate continuity of care and generally visit their GPs more often than the average patient. Our aim was to study disenrollment patterns among patients with chronic diseases in Norway, because such patterns could indicate otherwise unobserved GP quality. For instance, higher quality GPs could have both a greater share of patients with chronic diseases and lower disenrollment rates. Data on 384,947 chronic patients and 3,974 GPs for the years 2009-2011 were obtained from national registers, including patient and GP characteristics, disenrollment data, and patient list composition. The birth cohorts from 1940 and 1970 (146,906 patients) were included for comparison. Patient and GP characteristics, comorbidity, and patient list composition were analyzed using descriptive statistics. Patients' voluntary disenrollment was analyzed using logistic regression models. The GPs' proportion of patients with a given chronic disease varied more than expected when the allocation was purely random. The proportions of patients with different chronic diseases were positively correlated, partly due to comorbidity. Patients tended to have lower disenrollment rates from GPs who had higher shares of patients with the same chronic disease. Disenrollment rates were generally lower from GPs with higher shares of patients with arthritis or depression, and higher from GPs who had higher shares of patients with diabetes type 1 and schizophrenia. This was the same in the comparison group. Patients with a chronic disease appeared to prefer GPs who have higher shares of patients with the same disease. High shares of patients with some diseases were also negatively associated with disenrollment for all patient groups, while other diseases were positively associated. These findings may reflect the GPs' general quality, but could alternatively result from the GPs' specialization in particular diseases. The supportive findings for the comparison group make it more plausible that high shares of chronic patients could indicate GP quality.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 5 19%
Student > Bachelor 5 19%
Student > Master 5 19%
Other 2 7%
Researcher 2 7%
Other 3 11%
Unknown 5 19%
Readers by discipline Count As %
Medicine and Dentistry 6 22%
Nursing and Health Professions 4 15%
Pharmacology, Toxicology and Pharmaceutical Science 3 11%
Biochemistry, Genetics and Molecular Biology 2 7%
Computer Science 1 4%
Other 4 15%
Unknown 7 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 November 2017.
All research outputs
#9,303,261
of 12,114,099 outputs
Outputs from BMC Family Practice
#953
of 1,193 outputs
Outputs of similar age
#188,193
of 285,227 outputs
Outputs of similar age from BMC Family Practice
#18
of 25 outputs
Altmetric has tracked 12,114,099 research outputs across all sources so far. This one is in the 20th percentile – i.e., 20% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,193 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one is in the 16th percentile – i.e., 16% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 285,227 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 25 others from the same source and published within six weeks on either side of this one. This one is in the 24th percentile – i.e., 24% of its contemporaries scored the same or lower than it.