Can continuity of primary care decrease unscheduled secondary care use?

NHS hospitals are often overwhelmed by people presenting to hospital for care that is unexpected, in particular attending their A&E departments, and subsequently being admitted to hospital as an emergency. In considering reasons for this, it is natural to consider the potential influence of factors related to general practices where these people are registered. Sometimes the way practices are organised make their patients end up needing unplanned care from hospitals when they fall ill. In particular, we wish to determine whether having continuity of care (usually seeing the same doctor) can reduce the risk of having an unplanned hospital admission. We will use data from the Clinical Practice Research Datalink (CPRD), a nationally representative sample of general practices with data on every patient consultation. It is linked to another dataset, “Hospital Episode Statistics” (HES), which tell us about patients’ stays in hospital.

This current pilot project will investigate whether the linked CPRD/HES data contains the right sort of information to answer our question. We will investigate data suitable for assessing continuity of care received by individual patients, and also the data which relate to emergency admissions and A&E attendance. In the present project, we will only look at data on 10,000 patients aged over 65 to assess this. Buying this limited subset is much less expensive than requesting the full dataset. If the data do seem suitable, we will seek funding to carry out an analysis on the full CPRD dataset which consists of over 2 million patients.

Amount awarded: £62,606