Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study

Abstract Aims The risk and burden of cardiovascular disease (CVD) are higher in homeless than in housed individuals but population-based analyses are lacking. The aim of this study was to investigate prevalence, incidence and outcomes across a range of specific CVDs among homeless individuals. Methods and results Using linked UK primary care electronic health records (EHRs) and validated phenotypes, we identified homeless individuals aged ≥16 years between 1998 and 2019, and age- and sex-matched housed controls in a 1:5 ratio. For 12 CVDs (stable angina; unstable angina; myocardial infarction; sudden cardiac death or cardiac arrest; unheralded coronary death; heart failure; transient ischaemic attack; ischaemic stroke; subarachnoid haemorrhage; intracerebral haemorrhage; peripheral arterial disease; abdominal aortic aneurysm), we estimated prevalence, incidence, and 1-year mortality post-diagnosis, comparing homeless and housed groups. We identified 8492 homeless individuals (32 134 matched housed individuals). Comorbidities and risk factors were more prevalent in homeless people, e.g. smoking: 78.1% vs. 48.3% and atrial fibrillation: 9.9% vs. 8.6%, P < 0.001. CVD prevalence (11.6% vs. 6.5%), incidence (14.7 vs. 8.1 per 1000 person-years), and 1-year mortality risk [adjusted hazard ratio 1.64, 95% confidence interval (CI) 1.29–2.08, P < 0.001] were higher, and onset was earlier (difference 4.6, 95% CI 2.8–6.3 years, P < 0.001), in homeless, compared with housed people. Homeless individuals had higher CVD incidence in all three arterial territories than housed people. Conclusion CVD in homeless individuals has high prevalence, incidence, and 1-year mortality risk post-diagnosis with earlier onset, and high burden of risk factors. Inclusion health and social care strategies should reflect this high preventable and treatable burden, which is increasingly important in the current COVID-19 context.

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Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases

The Lancet ◽

10.1016/s0140-6736(19)31674-5 ◽

2019 ◽

Vol 394 (10203) ◽

pp. 1041-1054 ◽

Cited By ~ 53

Author(s):

Helen Strongman ◽

Sarah Gadd ◽

Anthony Matthews ◽

Kathryn E Mansfield ◽

Susannah Stanway ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Diseases ◽

Electronic Health Records ◽

Population Based ◽

Health Records ◽

Electronic Health

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Health Complaints in Individual Visiting Primary Health Care: Population-Based National Electronic Health Records of Iran

10.21203/rs.3.rs-579282/v1 ◽

2021 ◽

Author(s):

Farnaz Khatami ◽

Mohammad Shariati ◽

Zahra Abbasi ◽

Taulant Muka ◽

Leila Khedmat ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Electronic Health Records ◽

Medical Schools ◽

Population Based ◽

Educational Planning ◽

National Study ◽

Health Records ◽

Primary Health ◽

Electronic Health

Abstract Background The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were identified to determine primary health care (PHC) priorities for the educational planning of medical students in Iran. Methods A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred at least once to CHSCs to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015–2020, classified by the International Classification of Primary Care (ICPC-2), and statistically analyzed. The total number of complaints that recorded in system was 17,430,139. Results 59% of the referring patients were women. The highest number of referrals was related to the age group of 18–59 years (56.9%), while the lowest belonged to the elderly (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation). Conclusion High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.

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