Association between emergency department attendances, sociodemographic factors and long-term health conditions in the population of Norfolk and Waveney, England: Cross sectional study

Jones, Charlotte, Shabuz, Md Zillur Rahman, Bachmann, Max O. ORCID: https://orcid.org/0000-0003-1770-3506, Burke, Amanda, Brainard, Julii, Cullum, Rachel, Saunders, Michael, Dalton, Alice, Enwo, Oby and Steel, Nicholas ORCID: https://orcid.org/0000-0003-1528-140X (2024) Association between emergency department attendances, sociodemographic factors and long-term health conditions in the population of Norfolk and Waveney, England: Cross sectional study. PLoS One, 19 (5). ISSN 1932-6203

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Abstract

Introduction: Demand for urgent and emergency health care in England has grown over the last decade, for reasons that are not clear. Changes in population demographics may be a cause. This study investigated associations between inidviduals’ characteristics (including socioeconomic deprivation and long term health conditions (LTC)) and the frequency of emergency department (ED) attendances, in the Norfolk and Waveney subregion of the East of England. Methods: The study population was people who were registered with 91 of 106 Norfolk and Waveney general practices during one year from 1 April 2022 to 31 March 2023. Linked primary and secondary care and geographical data included each individual’s sociodemographic characteristics, and number of ED attendances during the same year and, for some individuals, LTCs and number of general practice (GP) appointments. Associations between these factors and ED attendances were estimated using Poisson regression models. Results: 1,027,422 individuals were included of whom 57.4% had GP data on the presence or absence of LTC, and 43.1% had both LTC and general practitioner appointment data. In the total population ED attendances were more frequent in individuals aged under five years, (adjusted Incidence Rate Ratio (IRR) 1.25, 95% confidence interval 1.23 to 1.28) compared to 15-35 years); living in more socioeconomically deprived areas (IRR 0.61 (0.60 to 0.63)) for least deprived compared to most deprived),and living closer to the nearest ED. Among individuals with LTC data, each additional LTC was also associated with increased ED attendances (IRR 1.16 (1.15 to 1.16)). Among individuals with LTC and GP appointment data, each additional GP appointment was also associated with increased ED attendances (IRR 1.03 (1.026 to 1.027)). Conclusions: In the Norfolk and Waveney population, ED attendance rates were higher for young children and individuals living in more deprived areas and closer to EDs. In individuals with LTC and GP appointment data, both factors were also associated with higher ED attendance.

Item Type:	Article
Additional Information:	Data Availability: Data availability statement The data are an individual level dataset containing information about each individual in the study population, including pseudonymised identify number, social and demographic information, and hospital and GP medical record data. Data are confidential pseudonymised medical records held by the Department of Public Health, Norfolk County Council, and not by the authors who are not authorised to legally distribute or share these data. Data analysis for the study has been done by the authors under a secure digital environment, and subject to the data governance training and requirements, of Norfolk County Council. Data requests may be sent to: Joint Strategic Needs Assessment, Norfolk County Council, County Hall, Martineau Lane, Norwich, Norfolk, NR1 2DH, email JSNA@norfolk.gov.uk. Funding: This research was funded by a grant from Public Health at Norfolk County Council (NCC) https://www.norfolk.gov.uk/. This paper presents independent analysis and research supported by NCC. The views expressed are those of the authors and not necessarily those of NCC, the NHS, or the Department of Health and Social Care. The funders did not have any role in the analysis or interpretation of data or in writing the manuscript.
Uncontrolled Keywords:	patient records,long-term health conditions,urgent and emergency care
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Depositing User:	LivePure Connector
Date Deposited:	08 May 2024 14:30
Last Modified:	16 May 2024 09:31
URI:	https://ueaeprints.uea.ac.uk/id/eprint/95092
DOI:	10.1371/journal.pone.0303270

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