The costs of care in general practice: patients compared by the council tax valuation band of their home address

Abstract

Background: It is difficult to measure and compare workload in UK general practice. A GP/health economist team recently proposed a means of calculating the unit cost of a GP consulting. It is therefore now possible to extrapolate to the costs of other clinical tasks in a practice and then to compare the workloads of caring for different patients and compare between practices.

Objectives: The study aims were: (i) to estimate the relative costs of daily clinical activities within a practice (implying workload); and (ii) to compare the costs of caring for different types of patients categorized by gender, by age, and by socio-economic status as marked by the Council Tax Valuation Band (CTVB) of home address.

Methods: The study design was a cross-sectional cost comparison of all clinical activity aggregated, by patient, over one year in an English semi-rural general practice. The subjects were 3339 practice patients, randomly selected. The main outcome measures were costs per clinical domain and overall costs per patient per year; both then compared by gender, age group and by CTVB.

Results: CTVB is as significant a predictor of patient care cost (workload) as is patient gender and age (both already known).

Conclusions: It is now possible to estimate the cost of care of different patients in such a way that NHS planning and especially resource allocation to practices could be improved.