Locums are independent contractors employed on a sessional basis to cover for permanent doctors either for a short or longer period. However, few studies have tested whether the quality and safety of care provided by locum doctors differ from those offered by permanent doctors. The specific objectives of the present study were as follows: To examine if there is a gender, specialty, age, and/or geographical distribution differential in clinical practice and prescribing safety of locum and permanent medical doctors in primary care in England.
Methodology
This study derived its data from electronic health care records (EHR) and involved 3. 5107771 patients from the CPRD GOLD database connected to the Hospital Episode Statistics from April 1st, 2010 till March 31st, 2022. Thereinto, via multi-level mixed effects logistic regression analysis, the author made a comparison of consultation outcomes between locum and permanent GPs, taking the considerations of patient and practice characteristics into account.
Results
Consultations with locum GPs were:
22% more likely to involve a prescription for antibiotics
8% more likely to involve a prescription for strong opioids
4% more likely to result in an A&E visit on the same day
5% more likely to result in an A&E visit within 1 to 7 days
Conversely, consultations with locum GPs were:
12% less likely to lead to a practice revisit within 7 days
4% less likely to involve a prescription for hypnotics
15% less likely to involve a referral
19% less likely to involve a test
No significant differences were found in emergency admissions, admissions for ambulatory care sensitive conditions (ACSC), or eight out of eleven prescribing safety indicators between patients seen by locum or permanent GPs.
Conclusions
Contrary to the above apprehension, our outcomes have revealed. That locum GPs no more are underperforming than permanent GPs in terms of clinical practice. The discussion has assumed from the outset that both locum. Permanent GPs are shaped by the organizational environment and structures in which they practice. They complement the knowledge of the person and focus on the conditions in primary care. Furthermore, as a part of an overarching, comprehensive healthcare system that should embrace all employees. Including those working in healthcare.
