The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Multimorbidity and risk among patients with established cardiovascular disease: a cohort study.
Most patients managed in primary care have more than one condition. Multimorbidity presents challenges for the patient and the clinician, not only in terms of the process of care, but also in terms of management and risk assessment. ⋯ Level of multimorbidity is an independent predictor of prognosis among patients with established cardiovascular disease. In such patients, the presence of chronic kidney disease carries a similar mortality risk to diabetes. Multimorbidity may be a useful factor in prioritising management of patients in the community with significant cardiovascular risk.
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Comparative Study
Enhancing a primary care environment: a case study of effects on patients and staff in a single general practice.
Few studies have examined the effect on patients and staff of the physical environment in primary care facilities. ⋯ This large-scale study examining the effects of a UK primary care environment on patients and staff shows that an enhanced environment is associated with improvements in patients' perception of patient-doctor communication, reduction in anxiety, and increases in patient and staff satisfaction.
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Does distance matter? Geographical variation in GP out-of-hours service use: an observational study.
GP cooperatives are typically based in emergency primary care centres, and patients are frequently required to travel to be seen. Geography is a key determinant of access, but little is known about the extent of geographical variation in the use of out-of-hours services. ⋯ There is geographical variation in out-of-hours service use. Patients from rural areas have lower call rates, but deprivation appears to be a greater determinant in urban areas. Geographical barriers must be taken into account when planning and delivering services.