Abstract

We read with great interest the article by Wilding and colleagues examining the association between constrained access to primary care and health-related quality of life (HRQoL) among full-time employees in England. Using a large population-based dataset and a robust instrumental variable approach, the authors demonstrate that work-related barriers to attending primary care appointments are associated with clinically meaningful reductions in EQ-5D-5L utility scores, particularly in physical health domains such as pain/discomfort and mobility. The larger effect observed among individuals with long-term conditions further highlights the equity implications of constrained access.