The impact of practice research activity on patient and practice outcomes

Problem

Research is fundamental to improving quality of care. Although research traditionally has an impact through implementation into routine care, there is increasing interest in whether participation in research itself drives better performance. The bulk of patient contacts are through general practice. If research participation improves outcomes, achieving those benefits through general practice could improve population health. However, the evidence that research activity improves outcomes mostly comes from secondary care.

Approach

We utilise data from the NIHR Clinical Research Network that contains the number of patients recruited into research at each practice. We conduct a cross-sectional regression analysis to investigate the cumulative impact of research recruitment on outcomes of interest such as CQC rating, QOF score and Patient satisfaction, whilst controlling for important practice characteristics. We extend the analysis using panel data regression to investigate the impact of becoming research active on subsequent changes to the outcomes of interest. This design controls for unmeasured factors that are broadly stable over time, such as effective leadership and organisational capability, which may be associated with both research participation and outcomes

Findings

Although the panel data analysis is ongoing, findings from the cross-sectional analysis show that patient satisfaction was not significantly related to research activity. Clinical quality measures were positively related to research activity. Practices with the highest research activity achieved 1% (CI 0.6,1.5) more quality indicator points compared to practices with no recruitment activity, and practices with the highest research activity had a 3.6% (CI 0.9, 6.4) higher probability of being rated ‘good’ or ‘outstanding’.

Consequences

We find that practices that participated in the highest levels of research activity achieved significantly higher levels of clinical quality measures, after controlling for a range of other practice characteristics. If these associations are replicated in the ongoing causal analysis, it would suggest that practice participation in research activity may be beneficial for clinical quality.