Continuity of care in general practice and secondary care: retrospective cohort study.

Background: Better continuity in primary and secondary care is linked to improved health outcomes, but it is unclear whether the sociodemographic determinants of continuity are the same in both settings and whether continuity measures in each setting are associated.

Aim: To examine the determinants of relational continuity in general practice (GP) and fragmented outpatient specialty care in people with clusters of Multiple Long-Term Conditions (LTCs) and the association between continuity in each setting.

Design And Setting: A cohort of patients ≥18 years registered to general practices in England throughout 2019, and with linked hospital outpatient records.

Post-operative periprosthetic femoral fractures in England: Patient profiles and short-term outcomes.

Background And Objective: Post-operative periprosthetic femoral fractures (POPFF) present a growing challenge for healthcare services, but there are limited national data on patient profiles, short-term outcomes, and post-discharge follow-up. We aimed to fill these gaps.

Methods: Using Hospital Episode Statistics (HES), we identified POPFF discharges from hospitals in England for patients aged 18 and above between April 2016 and December 2022.

The Impact of COVID-19 on Acute Surgeries in England Among the Under-25s: A Retrospective Study of 61,360 Appendicitis and 15,850 Testicular Torsion Admissions.

Background: Little is known about how COVID-19 impacted acute surgical activity for children and young people (CYP) across England. Appendicitis and testicular torsion are common surgical conditions where treatment delays can lead to avoidable complications. We undertook a retrospective national cohort study.

Has multimorbidity and frailty in adult hospital admissions changed over the last 15 years? A retrospective study of 107 million admissions in England.

Background: Few studies have quantified multimorbidity and frailty trends within hospital settings, with even fewer reporting how much is attributable to the ageing population and individual patient factors. Studies to date have tended to focus on people over 65, rarely capturing older people or stratifying findings by planned and unplanned activity. As the UK's national health service (NHS) backlog worsens, and debates about productivity dominate, it is essential to understand these hospital trends so health services can meet them.

Polypharmacy in primary care: A population-based retrospective cohort study of electronic health records.

Background: Polypharmacy, prescription of multiple medications to a patient, is a major challenge for health systems. There have been no peer-reviewed studies of polypharmacy prevalence and medication cost at a population level in England.

Aims: To determine prevalence and medication cost of polypharmacy, by patient characteristics.

Increased 30-day all-cause mortality associated with Gram-negative bloodstream infections in England during the COVID-19 pandemic.

Background: Our aim was to assess the impact of COVID-19 pandemic on mortality in patients hospitalised with Gram-negative bloodstream infections (GNBSIs).

Methods: A retrospective cohort study including cases of Escherichia coli, Klebsiella species and Pseudomonas aeruginosa in England (January 2015-December 2021) reported to UKHSA's Second Generation Surveillance System. The outcome was 30-day all-cause mortality.

Uptake of COVID-19 vaccines and association with hospitalisation due to COVID-19 in pregnancy: Retrospective cohort study.

Objectives: To determine demographic and clinical characteristics associated with uptake of COVID-19 vaccines among pregnant women, and quantify the relationship between vaccine uptake and admission to hospital for COVID-19.

Background: Pregnant women are at increased risk of severe adverse outcomes from COVID-19. Since April 2021, COVID-19 vaccines were recommended for pregnant women in the UK.

Identifying multi-resolution clusters of diseases in ten million patients with multimorbidity in primary care in England.

Background: Identifying clusters of diseases may aid understanding of shared aetiology, management of co-morbidities, and the discovery of new disease associations. Our study aims to identify disease clusters using a large set of long-term conditions and comparing methods that use the co-occurrence of diseases versus methods that use the sequence of disease development in a person over time.

Methods: We use electronic health records from over ten million people with multimorbidity registered to primary care in England.

Comparing natural language processing representations of coded disease sequences for prediction in electronic health records.

Objective: Natural language processing (NLP) algorithms are increasingly being applied to obtain unsupervised representations of electronic health record (EHR) data, but their comparative performance at predicting clinical endpoints remains unclear. Our objective was to compare the performance of unsupervised representations of sequences of disease codes generated by bag-of-words versus sequence-based NLP algorithms at predicting clinically relevant outcomes.

Materials And Methods: This cohort study used primary care EHRs from 6 286 233 people with Multiple Long-Term Conditions in England.

The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study.

Background: COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level.

Assigning disease clusters to people: A cohort study of the implications for understanding health outcomes in people with multiple long-term conditions.

Background: Identifying clusters of co-occurring diseases may help characterise distinct phenotypes of Multiple Long-Term Conditions (MLTC). Understanding the associations of disease clusters with health-related outcomes requires a strategy to assign clusters to people, but it is unclear how the performance of strategies compare.

Aims: First, to compare the performance of methods of assigning disease clusters to people at explaining mortality, emergency department attendances and hospital admissions over one year.

Treating insomnia in people who are incarcerated: a feasibility study of a multicomponent treatment pathway.

Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardized, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomized controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes.

Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study.

Objective: To describe the COVID-19 pandemic's impact on acute appendicitis management on children and young people (CYP).

Design: Retrospective cohort study.

Setting: All English National Health Service hospitals.

A service evaluation of passive remote monitoring technology for patients in a high-secure forensic psychiatric hospital: a qualitative study.

Background: Technology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients' perspectives on using passive remote monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders' perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation.

Identifying potential biases in code sequences in primary care electronic healthcare records: a retrospective cohort study of the determinants of code frequency.

Objectives: To determine whether the frequency of diagnostic codes for long-term conditions (LTCs) in primary care electronic healthcare records (EHRs) is associated with (1) disease coding incentives, (2) General Practice (GP), (3) patient sociodemographic characteristics and (4) calendar year of diagnosis.

Design: Retrospective cohort study.

Setting: GPs in England from 2015 to 2022 contributing to the Clinical Practice Research Datalink Aurum dataset.

Factors associated with enrolment into a national COVID-19 pulse oximetry remote monitoring programme in England: a retrospective observational study.

Background: Hypoxaemia is an important predictor of severity in individuals with COVID-19 and can present without symptoms. The COVID Oximetry @home (CO@h) programme was implemented across England in November, 2020, providing pulse oximeters to higher-risk people with COVID-19 to enable early detection of deterioration and the need for escalation of care. We aimed to describe the clinical and demographic characteristics of individuals enrolled onto the programme and to assess whether there were any inequalities in enrolment.

Evaluating the impact of a pulse oximetry remote monitoring programme on mortality and healthcare utilisation in patients with COVID-19 assessed in emergency departments in England: a retrospective matched cohort study.

Background: To identify the impact of enrolment onto a national pulse oximetry remote monitoring programme for COVID-19 (COVID-19 Oximetry @home; CO@h) on health service use and mortality in patients attending Emergency Departments (EDs).

Methods: We conducted a retrospective matched cohort study of patients enrolled onto the CO@h pathway from EDs in England. We included all patients with a positive COVID-19 test from 1 October 2020 to 3 May 2021 who attended ED from 3 days before to 10 days after the date of the test.

Characteristics associated with influenza vaccination uptake in pregnancy: a retrospective cohort study.

Background: Pregnant women are at increased risk from influenza, yet maternal influenza vaccination levels remain suboptimal.

Aim: To estimate associations between sociodemographic and health characteristics and seasonal influenza vaccination uptake among pregnant women, and to understand trends over time to inform interventions to improve vaccine coverage.

Design And Setting: Retrospective cohort study using linked electronic health records of women in North West London with a pregnancy overlapping an influenza season between September 2010 and February 2020.

Impact of COVID-19 on outpatient appointments in children and young people in England: an observational study.

Objectives: To describe the impact of the COVID-19 pandemic on outpatient appointments for children and young people.

Setting: All National Health Service (public) hospitals in England.

Participants: All people in England aged <25 years.

Patient outcomes following emergency admission to hospital for COVID-19 compared with influenza: retrospective cohort study.

Background: We examine differences in posthospitalisation outcomes, and health system resource use, for patients hospitalised with COVID-19 during the UK's first pandemic wave in 2020, and influenza during 2018 and 2019.

Methods: This retrospective cohort study used routinely collected primary and secondary care data. Outcomes, measured for 90 days follow-up after discharge were length of stay in hospital, mortality, emergency readmission and primary care activity.

Factors associated with, and variations in, COVID-19 hospital death rates in England's first two waves: observational study.

Objectives: To assess patient-level and hospital-level predictors of death and variation in death rates following admission for COVID-19 in England's first two waves after accounting for random variation. To quantify the correlation between hospitals' first and second wave death rates.

Design: Observational study using administrative data.