Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services

Objective This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient’s age, gender and depri...

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Main Authors: Richard Pebody, Simon de Lusignan, Gillian Smith, Alex J Elliot, Paul R Hunter, Kirsty E Morrison, Felipe J Colón-González, Roger A Morbey, Judith Rutter, Gareth Stuttard, Alex Yeates, Iain R Lake
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e038356.full
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author Richard Pebody
Simon de Lusignan
Gillian Smith
Alex J Elliot
Paul R Hunter
Kirsty E Morrison
Felipe J Colón-González
Roger A Morbey
Judith Rutter
Gareth Stuttard
Alex Yeates
Iain R Lake
author_facet Richard Pebody
Simon de Lusignan
Gillian Smith
Alex J Elliot
Paul R Hunter
Kirsty E Morrison
Felipe J Colón-González
Roger A Morbey
Judith Rutter
Gareth Stuttard
Alex Yeates
Iain R Lake
author_sort Richard Pebody
collection DOAJ
description Objective This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient’s age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions.Design Ecological study.Setting Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH).Participants 13 million respiratory contacts to NHS111, GPIH and GPOOH.Outcome measures Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH.Results More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15–44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar.Conclusion When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour.
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spelling doaj-art-0a2848dcdb124e2c8e37ffd4103d0c9e2024-11-25T07:30:09ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038356Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare servicesRichard Pebody0Simon de Lusignan1Gillian Smith2Alex J Elliot3Paul R Hunter4Kirsty E Morrison5Felipe J Colón-González6Roger A Morbey7Judith Rutter8Gareth Stuttard9Alex Yeates10Iain R Lake11World Health Organization Regional Office for Europe, Copenhagen, DenmarkNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK2 National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UKReal-time Syndromic Surveillance Team, Field Service, National Infection Service, Public Health England, Birmingham, UKprofessor in medicineSchool of Environmental Sciences, University of East Anglia, Norwich, UKSchool of Environmental Sciences, University of East Anglia, Norwich, UKReal-time Syndromic Surveillance Team, Field Service, National Infection Service, Public Health England, Birmingham, UKNHS Digital, Leeds, UK5 General Practice, Wake Green Surgery, Birmingham, UKAdvanced, Ashford, UKSchool of Environmental Sciences, University of East Anglia, Norwich, UKObjective This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient’s age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions.Design Ecological study.Setting Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH).Participants 13 million respiratory contacts to NHS111, GPIH and GPOOH.Outcome measures Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH.Results More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15–44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar.Conclusion When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour.https://bmjopen.bmj.com/content/10/11/e038356.full
spellingShingle Richard Pebody
Simon de Lusignan
Gillian Smith
Alex J Elliot
Paul R Hunter
Kirsty E Morrison
Felipe J Colón-González
Roger A Morbey
Judith Rutter
Gareth Stuttard
Alex Yeates
Iain R Lake
Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
BMJ Open
title Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
title_full Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
title_fullStr Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
title_full_unstemmed Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
title_short Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services
title_sort demographic and socioeconomic patterns in healthcare seeking behaviour for respiratory symptoms in england a comparison with non respiratory symptoms and between three healthcare services
url https://bmjopen.bmj.com/content/10/11/e038356.full
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