Predicting the workload in urban general practice in The Netherlands from Jarman's indicators of deprivation at patient level

Study objective - General practitioners (GPs) working in deprived areas supposedly have higher workloads. In the UK, this has led to a higher payment per patient from deprived areas, based on eight indicators of deprivation proposed by Jarman. This paper aimed to examine the applicability of the Jarman index (indicators and attached weights) at patient level in an urban GP setting outside the UK. Design - Data on all GP contacts were collected from 5121 residents aged 16 and over by interview. Setting - Amsterdam, The Netherlands, 1992-93. Main results - Results showed that six out of eight of the Jarman indicators of deprivation were indeed associated with higher GP contact rates in adults in Amsterdam, though some of them without statistical significance. The relative importance of the indicators, however, differed largely from Jarman's weights. In particular, people in poor housing, unskilled earners, and people born in a foreign country had higher contact rates. Furthermore, some indicators were highly inter-related at patient level. Conclusions - It is concluded that most of the Jarman indicators can be used to predict Amsterdam GP workload at patient level, but that their relative weights should be adapted for this aim. The applicability of the Jarman index (indicators and attached weights) in other European countries requires additional study.