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Lookup NU author(s): Professor Barbara HanrattyORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2024.Background: Healthcare in care homes during the COVID-19 pandemic required a balance, providing treatment while minimising exposure risk. Policy for how residents should receive care changed rapidly throughout the pandemic. A lack of accessible data on care home residents over this time meant policy decisions were difficult to make and verify. This study investigates common patterns of healthcare utilisation for care home residents in relation to COVID-19 testing events, and associations between utilisation patterns and resident characteristics. Methods: Datasets from County Durham and Darlington NHS Foundation Trust including secondary care, community care and a care home telehealth app are linked by NHS number used to define daily healthcare utilisation sequences for care home residents. We derive four 10-day sets of sequences related to Pillar 1 COVID-19 testing; before [1] and after [2] a resident’s first positive test and before [3] and after [4] a resident’s first test. These sequences are clustered, grouping residents with similar healthcare patterns in each set. Association of individual characteristics (e.g. health conditions such as diabetes and dementia) with healthcare patterns are investigated. Results: We demonstrate how routinely collected health data can be used to produce longitudinal descriptions of patient care. Clustered sequences [1,2,3,4] are produced for 3,471 care home residents tested between 01/03/2020–01/09/2021. Clusters characterised by higher levels of utilisation were significantly associated with higher prevalence of diabetes. Dementia is associated with higher levels of care after a testing event and appears to be correlated with a hospital discharge after a first test. Residents discharged from inpatient care within 10 days of their first test had the same mortality rate as those who stayed in hospital. Conclusion: We provide longitudinal, resident-level data on care home resident healthcare during the COVID-19 pandemic. We find that vulnerable residents were associated with higher levels of healthcare usage despite the additional risks. Implications of findings are limited by the challenges of routinely collected data. However, this study demonstrates the potential for further research into healthcare pathways using linked, routinely collected datasets.
Author(s): Garner A, Preston N, Caiado CCS, Stubington E, Hanratty B, Limb J, Mason SM, Knight J
Publication type: Article
Publication status: Published
Journal: BMC Geriatrics
Year: 2024
Volume: 24
Issue: 1
Print publication date: 01/12/2024
Online publication date: 23/05/2024
Acceptance date: 09/05/2024
Date deposited: 03/06/2024
ISSN (electronic): 1471-2318
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12877-024-05062-6
DOI: 10.1186/s12877-024-05062-6
Data Access Statement: Data was collected from CDDFT and stored in a Trusted Research Environment (TRE) managed by Durham University. Informed consent was not possible as the data was anonymised. The Trust shared anonymised data after undertaking a Data Privacy Impact Assessment and a Data Transfer Agreement. Data supporting this study is not publicly available due to ethical considerations around accessing linked patient level healthcare data. The authors can no longer access the data used in this analysis. Please contact the main author for more information (a.garner2@lancaster.ac.uk).
PubMed id: 38783195
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