Mason, S. orcid.org/0000-0002-1701-0577, Stone, T. orcid.org/0000-0002-0167-3800, Jacques, R. orcid.org/0000-0001-6710-5403 et al. (4 more authors) (2022) Creating a real-world linked research platform for analyzing the urgent and emergency care system. Medical Decision Making, 42 (8). pp. 999-1009. ISSN 0272-989X
Abstract
Background
This article describes the development of a system-based data platform for research developed to provide a detailed picture of the characteristics of the Urgent and Emergency Care system in 1 region of the United Kingdom.
Data Set Development
CUREd is an integrated research data platform that describes the urgent and emergency care system in 1 region of the United Kingdom on almost 30 million patient contacts within the system. We describe regulatory approvals required, data acquisition, cleaning, and linkage.
Data Set Analyses
The data platform covers 2011 to 2017 for 14 acute National Health Service (NHS) Hospital Trusts, 1 ambulance service, the national telephone advice service (NHS 111), and 19 emergency departments. We describe 3 analyses undertaken: 1) Analyzing triage patterns from the NHS 111 telephone helpline using routine data linked to other urgent care services, we found that the current triage algorithms have high rates of misclassifying calls. 2) Applying an algorithm to consistently identify avoidable attendances for pediatric patients, we identified 21% of pediatric attendances to the emergency department as avoidable. 3) Using complex systems analysis to examine patterns of frequent attendance in urgent care, we found that frequent attendance is stable over time but varies by individual patient. This implies that frequent attendance is more likely to be a function of the system overall.
Discussion
We describe the processes necessary to produce research-ready data that link care across the components of the urgent and emergency care system. Making the use of routine data commonplace will require partnership between the collectors, owners, and guardians of the data and researchers and technical teams.
Highlights
-This article describes the development of a system-level data platform for research using routine patient-level data from the urgent and emergency care system in 1 region of the United Kingdom.
-The article describes how the data were acquired, cleaned, and linked and the challenges faced when undertaking analysis with the data.
-The data set has been used to understand patient use of the system, journeys once in the system, and outcomes following its use, for example, patterns of frequent use within urgent care and accuracy of referral decisions within the system.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
Keywords: | data linkage; emergency care; health data; research-ready data; routine data; routine data analysis; urgent care |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Social Sciences (Sheffield) > Department of Sociological Studies (Sheffield) The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 19 May 2022 11:01 |
Last Modified: | 25 Oct 2022 13:24 |
Status: | Published |
Publisher: | SAGE Publications |
Refereed: | Yes |
Identification Number: | 10.1177/0272989X221098699 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:187068 |