Impact of Socioeconomic Status on Adult Patients with Asthma: A Population-Based Cohort Study from UK Primary Care

Background: Up to 70% of patients report ongoing symptoms four weeks after hospitalisation for pneumonia, and the impact on primary care is poorly understood. Aim: To investigate the frequency of primary care consultations after hospitalisation for pneumonia, and the reasons for consultation. Design: Population-based cohort study. Setting: UK primary care database of anonymised medical records (Clinical Practice Research Datalink, CPRD) linked to Hospital Episode Statistics (HES), England. Methods: Adults with the first ICD-10 code for pneumonia (J12-J18) recorded in HES between July 2002-June 2017 were included. Primary care consultation within 30 days of discharge was identified as the recording of any medical Read code (excluding administration-related codes) in CPRD. Competing-risks regression analyses were conducted to determine the predictors of consultation and antibiotic use at consultation; death and readmission were competing events. Reasons for consultation were examined. Results: Of 56,396 adults, 55.9% (n=31,542) consulted primary care within 30 days of discharge. The rate of consultation was highest within 7 days (4.7 per 100 person-days). The strongest predictor for consultation was a higher number of primary care consultations in the year prior to index admission (adjusted sHR 8.98, 95% CI 6.42-12.55). The commonest reason for consultation was for a respiratory disorder (40.7%, n=12,840), 12% for pneumonia specifically. At consultation, 31.1% (n=9,823) received further antibiotics. Penicillins (41.6%, n=5,753) and macrolides (21.9%, n=3,029) were the commonest antibiotics prescribed. Conclusion: Following hospitalisation for pneumonia, a significant proportion of patients consulted primary care within 30 days, highlighting the morbidity experienced by patients during recovery from pneumonia.

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Socioeconomic status and treatment of depression during pregnancy: a retrospective population-based cohort study in British Columbia, Canada

Archives of Women s Mental Health ◽

10.1007/s00737-018-0866-6 ◽

2018 ◽

Vol 21 (6) ◽

pp. 765-775 ◽

Cited By ~ 2

Author(s):

Gillian E. Hanley ◽

Mina Park ◽

Tim F. Oberlander

Keyword(s):

British Columbia ◽

Socioeconomic Status ◽

Cohort Study ◽

Population Based ◽

Treatment Of Depression

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Attendance of routine childcare visits in primary care for children of mothers with depression: a nationwide population-based cohort study

British Journal of General Practice ◽

10.3399/bjgp18x694565 ◽

2018 ◽

Vol 68 (667) ◽

pp. e97-e104 ◽

Cited By ~ 6

Author(s):

Bente Kjær Lyngsøe ◽

Claus Høstrup Vestergaard ◽

Dorte Rytter ◽

Mogens Vestergaard ◽

Trine Munk-Olsen ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Relative Risk ◽

Confidence Interval ◽

Maternal Depression ◽

Vaccination Programme ◽

Population Based ◽

Point Of Interest ◽

Vulnerable Families

BackgroundDepression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression.AimTo evaluate the association between maternal depression and offspring non-attendance to the Danish childcare and vaccination programme (CCP) for children from 0–5 years of age. The CCP consists of seven separate visits and several vaccinations. To investigate if exposure to recent and previous depression may affect attendance differently.Design and settingPopulation-based cohort study using Danish nationwide registers.MethodParticipants were all live-born children (n = 853 315) in Denmark in the period from 1 January 2000 until 31 August 2013, and their mothers. The outcome of interest was non-attendance of each one of the seven scheduled childcare visits and two vaccination entities in the CCP. Exposure was maternal (both previous and recent) depression. All information was obtained from Danish national registries.ResultsThe risk of not attending CCP was higher for children of mothers with depression. For children of mothers with previous depression, the relative risk (RR) was 1.01 (95% confidence interval [CI] = 0.98 to 1.03) at the 5-week childcare visit, and 1.12 (95% CI = 1.09 to 1.14) at the 5-year childcare visit. For children of mothers with recent depression, the RR was 1.07 (95% CI = 1.03 to 1.13) at the 5-week visit, and 1.15 (95% CI = 1.13 to 1.17) at the 5-year visit. Furthermore, the risk of missing at least four of the seven childcare visits was higher for children of females with maternal depression (RR = 1.16, 95% CI = 1.13 to 1.19).ConclusionMaternal depression seems to compromise CCP attendance. These findings suggest a need for careful clinical attention to these vulnerable families, even years after a diagnosis of depression.

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