Research opportunity in primary care.

INTRODUCTION The importance of primary health care has been recognised by the World Health Organisation (WHO) and given a major boost by the Alma Ata statement (1). Inequalities in patient care and the economics of health care delivery are the underlying reasons giving primary care its current importance. Inequalities in health care delivery even within a country, whether regionally, ethnically , social class or income determined, are increasingly unacceptable in most civilised societies. It is difŽ cult to conceive of a health care system which can achieve equality unless it does so at the basic primary care level. From another perspective it is difŽ cult to see cost-effective health care delivery if primary care is bypassed, giving patients direct access to a secondary health care service with its inevitable increased level of resource. Increased emphasis on primary care brings increased opportunities for epidemiological research, because the information availabl e to the general practitioner (GP) about the health of an individua l is increasingly comprehensive. The link between illness episodes and life-time events included in the patient record provides a golden opportunity for the doctor interested in research. In those countries in which individua l patient-speciŽ c data can be set within the context of a registered population , there is the even greater opportunity of deriving population based rates – the heart of epidemiological research. This presentation uses information gathered in primary care mainly in the practices of the sentinel practice network of the Royal College of General Practitioners based in Birmingham and known as the Weekly Returns Service (WRS) (2). The examples are chosen to provide a perspective of research opportunities in primary care.