Tendency to contact general practice instead of self-care : a population vignette study

Background: Demand for general practice in the UK is higher than supply. Some patients seek appointments with GPs for minor illnesses rather than self-care.

Aim: To identify the characteristics of people with a tendency to contact GPs rather than self-care.

Design & setting: A national survey of the British adult population was undertaken in 2018, which included vignettes.

Method: Two vignettes focused on illness in adults: half of responders completed a vignette about cough and sore throat for 3 days, and the other half completed a vignette about diarrhoea and vomiting for 2 days. Logistic regression was undertaken to identify characteristics associated with contacting GPs compared with dealing with the problem themselves, calling NHS 111, or contacting another service, including a pharmacist.

Results: The response rate was 42%, with 2906 responders. Responders were twice as likely to select ‘contact GP’ for the diarrhoea and vomiting vignette than for the cough and sore throat vignette (44.7% versus 21.8%). Factors associated with tendency for GP contact included being aged >75 years (odds ratio [OR] 2.0, 95% confidence interval [CI] = 1.2 to 3.2); from black, Asian and minority ethnic (BAME) communities (OR 2.1, 95% CI = 1.5 to 3.0); feeling overwhelmed by unexpected health problems (OR 1.4, 95% CI = 0.99 to 2.1); lower health literacy (OR 1.2, 95% CI = 1.0 to 1.4); and believing that general practice is not overused (OR 1.3, 95% CI = 1.1 to 1.7).

Conclusion: Type of symptom, personal characteristics, and population beliefs about general practice utilisation explain the tendency to contact GPs for minor illness amenable to self-care.