@article {Hann894, author = {Mark Hann and Hugh Gravelle}, title = {The maldistribution of general practitioners in England and Wales: 1974{\textendash}2003}, volume = {54}, number = {509}, pages = {894--898}, year = {2004}, publisher = {Royal College of General Practitioners}, abstract = {Background: The geographical distribution of general practitioners (GPs) is a persistent policy concern within the National Health Service. Maldistribution across family health service authorities in England and Wales fell between 1974 and the mid-1980s but then remained, at best, constant until the mid-1990s.Aim: To estimate levels of maldistribution over the period 1994{\textendash}2003 and to examine the long-term trend in maldistribution from 1974{\textendash}2003.Design: Annual snapshots from the GP census.Setting: One hundred 2001 {\textquoteleft}frozen{\textquoteright} health authorities in England and Wales for 1994{\textendash}2003 and 98 family health service authorities for 1974{\textendash}1995.Method: Ratios of GPs to raw and need-adjusted populations were calculated for each health authority for each year using four methods of need adjustment: age-related capitation payments, national age- and sex-specific consultation rates, national age- and sex-specific limiting long-term illness rates, and health authority-specific mortality. Three summary measures of maldistribution across health authorities in the GP to population ratio {\textemdash} the decile ratio, the Gini coefficient, and the Atkinson index {\textemdash} were calculated for each year.Results: Maldistribution of GPs as measured by the Gini coefficient and Atkinson index increased from the mid-1980s to 2003, but the decile ratio showed little change over the entire 1974{\textendash}2003 period. Unrestricted GP principals and equivalents were more equitably distributed than other types of GP.Conclusion: The 20\% increase in the number of unrestricted GPs between 1985 and 2003 did not lead to a more equal distribution.}, issn = {0960-1643}, URL = {https://bjgp.org/content/54/509/894}, eprint = {https://bjgp.org/content/54/509/894.full.pdf}, journal = {British Journal of General Practice} }