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Table 2 Summary of the sources of powerlessness perceived by GPs as preventing them from influencing childhood hospital admissions

From: General practitioners’ views on quality markers for children in UK primary care: a qualitative study

Patient Patient morbidity
Health service use behaviour
Parents request second opinion
Caregivers failure to give medication
Chaotic lifestyle of caregiver
Parents coping strategy
Severity of illness
Health care system Lack of facilities to observe sick children
  Lack of senior doctors in emergency department
Varying quality of out-of-hours care physicians
Inadequate health care facilities
Varying admission thresholds at hospital
Societal Education of population
  Outbreaks of illnesses
Bank holidays / vacation dates
Conflicting health messages
Deprivation and poverty
Cultural factors