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Monitoring Fairness in the NHS

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2019

ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing

John, W., Hayward, A., West, J., Pickett, K., Mceachan, R., Mon-Williams, M., Christie, N., Vaughan, L., Sheringham, J., Haklay, M., Sheard, L., Dickerson, J., Barber, S., Small, N., Cookson, R. A., Garnett, P. R., Bywater, T. J., Pleace, N., Brunner, E., Cameron, C. & 17 othersUcci, M., Cummins, S., Fancourt, D., Kandt, J., Longley, P., Morris, S., Ploubidis, G. B., Savage, R., Aldridge, R., Hopewell, D., Yang, T., Mason, D., Santorelli, G., Romano, R., Bryant, M., Crosby, L. & Sheldon, T. A., 14 Oct 2019

Article in Wellcome Open Research

Publication details

Journal Wellcome Open Research
Date Accepted/In press - 14 Oct 2019
Date Published (current) - 14 Oct 2019
Number of pages 14
Pages (from-to) 1-14
Original language English

Bibliographical note

© 2019 Meier P.

Publication details

Journal Health services research
Date Submitted - 12 May 2018
Date Accepted/In press - 22 Aug 2019
Date E-pub ahead of print (current) - 9 Oct 2019
Number of pages 1
Pages (from-to) 10
Early online date 9/10/19
Original language English

Abstract

Objective: To investigate whether continuity of care in family practice reduces unplanned hospital use for people with serious mental illness (SMI). Data Sources Linked administrative data on family practice and hospital utilization by people with SMI in England, 2007-2014. Study Design: This observational cohort study used discrete-time survival analysis to investigate the relationship between continuity of care in family practice and unplanned hospital use: emergency department (ED) presentations, and unplanned admissions for SMI and ambulatory care-sensitive conditions (ACSC). The analysis distinguishes between relational continuity and management/ informational continuity (as captured by care plans) and accounts for unobserved confounding by examining deviation from long-term averages. Data Collection/Extraction Methods: Individual-level family practice administrative data linked to hospital administrative data. Principal Findings: Higher relational continuity was associated with 8-11 percent lower risk of ED presentation and 23-27 percent lower risk of ACSC admissions. Care plans were associated with 29 percent lower risk of ED presentation, 39 percent lower risk of SMI admissions, and 32 percent lower risk of ACSC admissions. Conclusions: Family practice continuity of care can reduce unplanned hospital use for physical and mental health of people with SMI.

Bibliographical note

© 2019 The Authors

Publication details

Journal Social Science & Medicine
Date Accepted/In press - 21 Jun 2019
Date E-pub ahead of print - 10 Jul 2019
Date Published (current) - Aug 2019
Volume 235
Number of pages 10
Early online date 10/07/19
Original language English

Bibliographical note

© 2019 Elsevier Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

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EQUIPOL is supported by the University of York, the Wellcome Trust (Grant No. 205427/Z/16/Z) and the NIHR (SRF-2013-06-015).

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