{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:21:24Z","timestamp":1765610484561,"version":"3.48.0"},"reference-count":32,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100010677","name":"H2020 Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,5]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Respiratory infections are associated with acute exacerbations of asthma and accompanying morbidity and mortality. In this study we explore inter-practice variations in respiratory infections in children with asthma and study the effect of practice-level factors on these variations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We analysed data from 164 general practices in the Royal College of General PractitionersResearch and Surveillance Centresentinel network in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children 5\u201312 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>None. In this observational study, we used regression analysis to explore the impact of practice-level determinants on the number of respiratory infections in children with asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We describe the distribution of childhood asthma and the determinants of upper\/lower\u2009respiratory tract infections in these children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>83.5% (137\/164) practices were in urban locations; the mean number of general practitioners per practice was 7; and the mean duration since qualification 19.7 years. We found almost 10-fold difference in the rate of asthma (1.5\u201311.8 per 100 children) and 50-fold variation in respiratory infection rates between practices. Larger practices with larger lists of asthmatic children had greater rates of respiratory infections among these children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We showed that structural\/environmental variables are consistent predictors of a range of respiratory infections among children with asthma. However, contradictory results between measures of practice clinical care show that a purely structural explanation for variability in respiratory infections is limited. Further research is needed to understand how the practice factors influence individual risk behaviours relevant to respiratory infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024372","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T06:28:41Z","timestamp":1548397721000},"page":"e024372","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of inter-practice variation in childhood asthma and respiratory infections: cross-sectional study of a national sentinel network"],"prefix":"10.1136","volume":"9","author":[{"given":"Uy","family":"Hoang","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshana","family":"Liyanage","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Coyle","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Godden","sequence":"additional","affiliation":[{"name":"St Mary\u2019s Hospital, Isle of Wight, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK"},{"name":"Division of Healthcare Delivery Science\/ Center for Healthcare Innovation and Delivery Science (CHIDS), Department of Population Health, New York University, Langone Medical Centre, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitch","family":"Blair","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Rigby","sequence":"additional","affiliation":[{"name":"Section of Paediatrics, School of Medicine, Imperial College London, St. Mary\u2019s Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"de Lusignan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK"},{"name":"Research and Surveillance Centre, Royal College of General Practitioners, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,24]]},"reference":[{"key":"2025121223162555000_9.1.e024372.1","unstructured":"Asthma statistics: British Lung Foundation. https:\/\/statistics.blf.org.uk\/asthma"},{"key":"2025121223162555000_9.1.e024372.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.066407"},{"key":"2025121223162555000_9.1.e024372.3","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/S0140-6736(13)61536-6","article-title":"Asthma","volume":"382","author":"Martinez","year":"2013","journal-title":"The Lancet"},{"key":"2025121223162555000_9.1.e024372.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2005.08.025"},{"key":"2025121223162555000_9.1.e024372.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0007484","article-title":"Increasing short-stay unplanned hospital admissions among children in England; 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