The influence of population characteristics on variation in general practice based morbidity estimations

Catharina van den Dungen, Nancy Hoeymans, Hendriek C. Boshuizen, Marjan van den Akker, Marion C. J. Biermans, Kees van Boven, Henk J. Brouwer, Robert A. Verheij, Margot W. M. de Waal, Francois G. Schellevis, Gert P. Westert

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16 Citations (Scopus)


Background: General practice based registration networks (GPRNs) provide information on morbidity rates in the population. Morbidity rate estimates from different GPRNs, however, reveal considerable, unexplained differences. We studied the range and variation in morbidity estimates, as well as the extent to which the differences in morbidity rates between general practices and networks change if socio-demographic characteristics of the listed patient populations are taken into account. Methods: The variation in incidence and prevalence rates of thirteen diseases among six Dutch GPRNs and the influence of age, gender, socio economic status (SES), urbanization level, and ethnicity are analyzed using multilevel logistic regression analysis. Results are expressed in median odds ratios (MOR). Results: We observed large differences in morbidity rate estimates both on the level of general practices as on the level of networks. The differences in SES, urbanization level and ethnicity distribution among the networks' practice populations are substantial. The variation in morbidity rate estimates among networks did not decrease after adjusting for these socio-demographic characteristics. Conclusion: Socio-demographic characteristics of populations do not explain the differences in morbidity estimations among GPRNs
Original languageEnglish
Article number887
Pages (from-to)887
JournalBMC public health
Issue number1
Publication statusPublished - 2011

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