The impact of multimorbidity on care pathways during COPD hospitalisations
Dataset
Summary
Citation:
The impact of multimorbidity on care pathways during COPD hospitalisations
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
Physical Sample Availability:
NOT AVAILABLE
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:
- ACCIDENT AND EMERGENCY
- IN-PATIENTS
- OUTPATIENTS
Temporal
Accrual Periodicity:
QUARTERLY
Distribution Release Date:
2021-12-17
Start Date:
2018-01-01
End Date:
2018-12-31
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:
1-2 MONTHS
Jurisdictions:
GB-ENG
Data Controller:
University Hospitals Birmingham NHS Foundation Trust
Data Processor:
NOT APPLICABLE
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:
- ICD10
- SNOMED CT
Conforms To:
LOCAL
Languages:
en
Formats:
SQL
Enrichment and Linkage
Derivations:
Not Available
Observations
Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Events
846 admissions of worsening COPD between 01-01-2018 to 31-12-2018
846
Count
2021-12-17