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dc.contributor.authorHetlevik, Øystein
dc.contributor.authorMelbye, Hasse
dc.contributor.authorGjesdal, Sturla
dc.date.accessioned2017-03-08T15:10:46Z
dc.date.available2017-03-08T15:10:46Z
dc.date.issued2016-06-09
dc.description.abstractThere is a marked socioeconomic gradient in the prevalence of chronic obstructive pulmonary disease (COPD) and asthma, but a large proportion of patients remain undiagnosed. It is a challenge for general practitioners (GPs) to both identify patients and contribute to equity and high quality in services delivered. The aim of this study was to identify patients with COPD and asthma diagnoses recorded by GPs and explore their utilisation of GP services by education level. This was a cross-sectional, national, register-based study from Norwegian general practice in the period 2009–2011. Based on claims from GPs, the number of patients aged ⩾40 years with a diagnosis of COPD or asthma and their GP services utilisation were estimated and linked to the national education database. Multivariate Poisson and logistic regression models were used to explore the variations in GP utilisation. In the population aged ⩾40 years, 2.8% had COPD and 3.8% had asthma according to GPs’ diagnoses. COPD was four times more prevalent in patients with basic education than higher education; this increase was ⩽80% for asthma. Consultation rates were 12% higher (P<0.001) for COPD and 25% higher (P<0.001) for asthma in patients with low versus high education in the age group of 40–59 years after adjusting for comorbidity, and patient and GP characteristics. Approximately 25% of COPD patients and 20% of asthma patients had ⩾1 spirometry test in general practice in 2011, with no significant education differences in adjusted models. The higher consultation rate in lower-education groups indicates that GPs contribute to fair distribution of healthcare.en_US
dc.descriptionPublished version. Source at <a href=http://doi.org/10.1038/npjpcrm.2016.27>http://doi.org/10.1038/npjpcrm.2016.27</a>. License <a href=https://creativecommons.org/licenses/by/4.0/>CC BY 4.0</a>.en_US
dc.identifier.citationHetlevik Ø, Melbye H, Gjesdal S. GP utilisation by education level among adults with COPD or asthma: A cross-sectional register-based study. Npj Primary Care Respiratory Medicine. 2016;26:16027en_US
dc.identifier.cristinIDFRIDAID 1370790
dc.identifier.doi10.1038/npjpcrm.2016.27
dc.identifier.issn2055-1010
dc.identifier.urihttps://hdl.handle.net/10037/10486
dc.language.isoengen_US
dc.publisherMacmillan Publishers Limiteden_US
dc.relation.journalNpj Primary Care Respiratory Medicine
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750en_US
dc.titleGP utilisation by education level among adults with COPD or asthma: A cross-sectional register-based studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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