Collecting morbidity data in general practice: the Somerset morbidity project

Abstract

Objective: To collect a valid, complete, continuous, and representative database of morbidity presenting to primary care and to use the data to help commission services on the basis of local need and effectiveness. Setting: Computerised general practices in Somerset. Methods: Participating general practices were selected to be representative of the district health authority population for general practice and population characteristics. All conditions presented at face to face consultations were assigned a Read code and episode type and the data were regularly validated. Data were sent by modem from the practices via a third party to the health authority each week. Main outcome measures: Proportion of consultations coded and accuracy of coding. Results: 11 practices agreed to participate. Validations for completeness during April 1994 to March 1995 revealed that 96.4% of the records were coded; 94% of the 1090 records validated had appropriate episode types and 87% appropriate Read codes. The results have been used to help formulate the health authority's purchasing plans and have enabled a change in the local contracts for surgery for glue ear. Conclusions: The project has shown the feasibility of establishing a network of practices recording and reporting the morbidity seen in primary care. Early indications are that the data can be useful in evidence based purchasing. This study shows that general practitioners will contribute to a morbidity database if given fi- nancial support and confidentiality is safeguarded Validation procedures ensure that the data are high quality Information from the database can be used to purchase health care based on the population's needs as well as to monitor and improve the health of the population