Deprivation and general practitioners' working lives: Repeated cross-sectional study

贫困与全科医生的工作生活:一项重复横断面研究

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Abstract

ObjectivesTo examine how area deprivation affects the working lives of general practitioners (GPs).DesignWe analysed responses to four repeated cross-sectional surveys between 2015 and 2021. We used linear regression to relate the population deprivation ranking of the GP's practice to job pressures, job satisfaction, intentions to quit direct patient care and hours worked. We used interval regression to relate reported income from GP work to this same deprivation ranking. We adjusted for GP characteristics, including employment status, gender, age and years qualified.SettingPrimary medical care in England.ParticipantsGPs.Main outcome measuresFourteen reported job pressures, 10 domains of job satisfaction, intentions to quit direct patient care, reported income from GP work and hours worked per week.ResultsDeprivation ranking was significantly associated with higher pressures related to perceived problem patients (difference between lowest and highest deprivation = 0.258 on five-point scale, 95% CI: 0.165, 0.350), insufficient resources within the practice (0.229, 95% CI: 0.107, 0.351), and finding a locum (0.260, 95% CI: 0.130, 0.390). Deprivation ranking was also associated with significantly lower reported annual income (-£5,525, 95% CI: -£8,773, -£2,276). There were no statistically significant associations between deprivation ranking and the other outcome measures.ConclusionsPerceived problem patients, insufficient resources and finding temporary cover are key drivers of GP job pressures in practices serving more deprived populations. GPs in more deprived areas also report lower incomes. These factors should be the target of increased investment and policy interventions to improve recruitment and retention of GPs in these areas.

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