Deaths and hospital admissions during cold weather: derivation and validation of a tool to help primary care identify vulnerable people

Cold weather poses challenges to primary care, both to prevent deaths and hospital admissions, and to treat resulting illnesses. Around 24,000 deaths are attributed to cold weather each year in England and Wales. It was recently recommended that GPs identify patients living in ‘hard to heat’ homes, but GPs are already over-stretched and do not have the tools to identify patients at highest risk. Using three datasets, we will develop a tool to help primary care teams identify people at risk of death or emergency admission to hospital during or just after cold spells.

The first dataset comprises over 2 million patients from general practices across Great Britain. We will use it to find out which aspects of people’s backgrounds and their medical history predict their risk of dying or going to hospital during or just after a cold weather spell. We will also find out whether people have much contact with primary care before a cold spell, so we can know whether primary care teams have any opportunity to intervene.

The second study, of older British men (now aged 74-95) includes a recent questionnaire about whether people find their homes hard to heat, how much they stay at home, and how active they are in cold weather. We will find out what sort of people find it hard to keep warm in winter. This study has been going on for many years so will use this second dataset to test the accuracy of the tool developed in the first study. The third dataset is similar and consists of 290 people from Oxfordshire who experienced a mini stroke before 1988. Together, these datasets will identify people most at risk of death or hospital admission during cold weather, and how much primary care professionals might be able to prevent these occurrences.