Do practice characteristics explain differences in morbidity estimates between electronic health record based general practice registration networks?

C. van den Dungen*, N. Hoeymans, M. van den Akker, M. C. J. Biermans, K. van Boven, J. H. K. Joosten, R. A. Verheij, M. W. M. de Waal, F. G. Schellevis, J. A. M. van Oers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)


Background: General practice based registration networks (GPRNs) provide information on population health derived from electronic health records (EHR). Morbidity estimates from different GPRNs reveal considerable, unexplained differences. Previous research showed that population characteristics could not explain this variation. In this study we investigate the influence of practice characteristics on the variation in incidence and prevalence figures between general practices and between GPRNs. Methods: We analyzed the influence of eight practice characteristics, such as type of practice, percentage female general practitioners, and employment of a practice nurse, on the variation in morbidity estimates of twelve diseases between six Dutch GPRNs. We used multilevel logistic regression analysis and expressed the variation between practices and GPRNs in median odds ratios (MOR). Furthermore, we analyzed the influence of type of EHR software package and province within one large national GPRN. Results: Hardly any practice characteristic showed an effect on morbidity estimates. Adjusting for the practice characteristics did also not alter the variation between practices or between GPRNs, as MORs remained stable. The EHR software package 'Medicom' and the province 'Groningen' showed significant effects on the prevalence figures of several diseases, but this hardly diminished the variation between practices. Conclusion: Practice characteristics do not explain the differences in morbidity estimates between GPRNs.
Original languageEnglish
Article number176
JournalBMC Family Practice
Publication statusPublished - 30 Oct 2014


  • Family practice
  • Incidence
  • Electronic medical records
  • Practice characteristics
  • Population health
  • Prevalence

Cite this