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Version: 1.0.0 | Published: 8 Oct 2024 | Updated: 228 days ago

The impact of multimorbidity on care pathways during COPD hospitalisations

Dataset

Documentation

Description:
Many patients admitted to hospital have multiple long-term conditions (MLTCs), also known as multimorbidity. Despite this, care delivery in hospital is designed for the treatment of single conditions. Often, the care of patients with multimorbidity can be unsatisfactory, inefficient and expensive. Chronic Obstructive Pulmonary Disease (COPD) is associated with a high burden of co-morbidities which tend to co-exist in specific disease clusters. Recognising their presence enables holistic patient management, but also offers opportunities to identify common biological mechanisms across diseases which might be therapeutically targetable. The most common comorbidities in COPD include cardiovascular disease, diabetes, depression and osteoporosis. Often presentations are badged as exacerbations and alternative causes of breathlessness are missed. This dataset includes 846 patients with COPD admitted to hospital. The infographic includes data from 01/01/2018 to 31/12/2018, but data is available from the past 10 years+. Data includes detailed demography, presenting symptoms, co-morbidities, admission diagnosis, laboratory tests, serial physiology, prescribed and administered drugs, use of non-invasive and invasive ventilation, and outcomes. Data can be matched to lung function for a proportion of patients. PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: All patients admitted to hospital for COPD exacerbations. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (temperature, BMI, blood pressure, respiratory rate, NEWS2 score, oxygen saturations and others), Sample analysis results (urea, albumin, platelets, white blood cells and others) drug administered and all outcomes. Linked images available (radiographs, CT scans, MRI). Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Coverage

Spatial:
United Kingdom,England,West Midlands
Typical Age Range:
20-95
Follow Up:
1 - 10 Years
Pathway:
Data is representative of the multi-ethnicity population within the West Midlands (42% non white). Data includes all patients admitted during this timeframe, with National data Opt Outs applied, and therefore is representative of admissions to secondary care. Data focuses on in-patient stay in hospital during the acute episode but can be supplemented on request to include previous and subsequent hospital contacts (including outpatient appointments) and ambulance, 111, 999 data.

Provenance

Origin

Purposes:
Care
Sources:
EPR
Collection Situations:
  • Secondary care - Accident and Emergency
  • Secondary care - In-patients
  • Secondary care - Outpatients

Temporal

Accrual Periodicity:
Quarterly
Distribution Release Date:
17 December 2021
Start Date:
01 January 2018
End Date:
31 December 2018
Time Lag:
Other

Accessibility

Access

Access Service:
Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets. Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs. Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.
Access Request Cost:
www.pioneerdatahub.co.uk/data/data-services-costs/
Delivery Lead Time:
Not applicable
Jurisdictions:
GB-ENG
Data Controller:
University Hospitals Birmingham NHS Foundation Trust

Usage

Data Use Limitations:
General research use
Data Use Requirements:
Project-specific restrictions
Resource Creators:
This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Format and Standards

Vocabulary Encoding Schemes:
  • SNOMED CT
  • ICD10
Conforms To:
LOCAL
Languages:
en
Formats:
SQL

Observations

Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Persons
846 admissions of worsening COPD between 01-01-2018 to 31-12-2018
846
Count
17 December 2021