RT Journal Article SR Electronic T1 Chronic care services and variation between Danish general practices: a nationwide cohort study JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e285 OP e292 DO 10.3399/BJGP.2021.0419 VO 72 IS 717 A1 Anders Prior A1 Claus Høstrup Vestergaard A1 Anette Riisgaard Ribe A1 Annelli Sandbæk A1 Flemming Bro A1 Peter Vedsted A1 Susan Smith A1 Mogens Vestergaard A1 Morten Fenger-Grøn YR 2022 UL http://bjgp.org/content/72/717/e285.abstract AB Background Little is known about variations in the provision of chronic care services in primary care.Aim To describe the frequency of chronic care services provided by GPs and analyse the extent of non-random variation in service provision.Design and setting Nationwide cohort study undertaken in Denmark using data from 2016.Method Information on chronic care services was obtained from national health registers, including annual chronic care consultations, chronic care procedures, outreach home visits, and talk therapy. The associations between services provided, patient morbidity, and socioeconomic factors were estimated. Service variations were analysed, and excess variation related to practice-specific factors was estimated while accounting for random variation.Results Chronic care provision was associated with increasing patient age, increasing number of long-term conditions, and indicators of low socioeconomic status. Variation across practices ranged from 1.4 to 128 times more than expected after adjusting for differences in patient population and random variation. Variation related to practice-specific factors was present for all the chronic care services that were investigated. Older patients with lower socioeconomic status and multimorbidity were clustered in practices with low propensity to provide certain chronic care services.Conclusion Chronic care was provided to patients typically in need of health care, that is, older adults, those with multimorbidity, and those with low socioeconomic status, but service provision varied more than expected across practices. GPs provided slightly fewer chronic care services than expected in practices where many patients with multimorbidity and low socioeconomic status were clustered, suggesting inverse care law mechanisms.