Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services

Kirsty E. Morrison; Felipe J. Colón-González; Roger A. Morbey; Paul R. Hunter; Judith Rutter; Gareth Stuttard; Simon De Lusignan; Alex Yeates; Richard Pebody; Gillian Smith; Alex J. Elliot; Iain R. Lake

doi:10.1136/bmjopen-2020-038356

Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services

Kirsty E. Morrison^*, Felipe J. Colón-González, Roger A. Morbey, Paul R. Hunter, Judith Rutter, Gareth Stuttard, Simon De Lusignan, Alex Yeates, Richard Pebody, Gillian Smith, Alex J. Elliot, Iain R. Lake

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

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Abstract

Objective: This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient's age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions.

Design: Ecological study.

Setting: Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH).

Participants: 13 million respiratory contacts to NHS111, GPIH and GPOOH.

Outcome measures: Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH.

Results: More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15-44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar.

Conclusion: When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour.

Original language	English
Article number	e038356
Journal	BMJ Open
Volume	10
Issue number	11
DOIs	https://doi.org/10.1136/bmjopen-2020-038356
Publication status	Published - 6 Nov 2020

Bibliographical note

Funding Information: This study was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England or the Department of Health and Social Care.

Open Access: This is an open access article distributed in accordance with the
Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits
others to copy, redistribute, remix, transform and build upon this work for any
purpose, provided the original work is properly cited, a link to the licence is given,
and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Publisher Copyright: © Author(s) (or their employer(s)) 2020. Published by BMJ.

Citation: Morrison KE, Colón-González FJ, Morbey RA, et al. Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services. BMJ Open 2020;10:e038356.

DOI: 10.1136/bmjopen-2020-038356

Keywords

epidemiology
respiratory infections
statistics & research methods

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Morrison, K. E., Colón-González, F. J., Morbey, R. A., Hunter, P. R., Rutter, J., Stuttard, G., De Lusignan, S., Yeates, A., Pebody, R., Smith, G., Elliot, A. J., & Lake, I. R. (2020). Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services. BMJ Open, 10(11), Article e038356. https://doi.org/10.1136/bmjopen-2020-038356

@article{321b5fc993cd48eb98348c28e65cdca6,

title = "Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services",

abstract = "Objective: This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient's age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions. Design: Ecological study. Setting: Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH). Participants: 13 million respiratory contacts to NHS111, GPIH and GPOOH. Outcome measures: Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH. Results: More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15-44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar. Conclusion: When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour. ",

keywords = "epidemiology, respiratory infections, statistics & research methods",

author = "Morrison, {Kirsty E.} and Col{\'o}n-Gonz{\'a}lez, {Felipe J.} and Morbey, {Roger A.} and Hunter, {Paul R.} and Judith Rutter and Gareth Stuttard and {De Lusignan}, Simon and Alex Yeates and Richard Pebody and Gillian Smith and Elliot, {Alex J.} and Lake, {Iain R.}",

note = "Funding Information: This study was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King{\textquoteright}s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England or the Department of Health and Social Care. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2020. Published by BMJ. Citation: Morrison KE, Col{\'o}n-Gonz{\'a}lez FJ, Morbey RA, et al. Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services. BMJ Open 2020;10:e038356. DOI: 10.1136/bmjopen-2020-038356 ",

year = "2020",

month = nov,

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Morrison, KE, Colón-González, FJ, Morbey, RA, Hunter, PR, Rutter, J, Stuttard, G, De Lusignan, S, Yeates, A, Pebody, R, Smith, G, Elliot, AJ & Lake, IR 2020, 'Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services', BMJ Open, vol. 10, no. 11, e038356. https://doi.org/10.1136/bmjopen-2020-038356

Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services. / Morrison, Kirsty E.; Colón-González, Felipe J.; Morbey, Roger A. et al.
In: BMJ Open, Vol. 10, No. 11, e038356, 06.11.2020.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England

T2 - A comparison with non-respiratory symptoms and between three healthcare services

AU - Morrison, Kirsty E.

AU - Colón-González, Felipe J.

AU - Morbey, Roger A.

AU - Hunter, Paul R.

AU - Rutter, Judith

AU - Stuttard, Gareth

AU - De Lusignan, Simon

AU - Yeates, Alex

AU - Pebody, Richard

AU - Smith, Gillian

AU - Elliot, Alex J.

AU - Lake, Iain R.

N1 - Funding Information: This study was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England or the Department of Health and Social Care. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. Publisher Copyright: © Author(s) (or their employer(s)) 2020. Published by BMJ. Citation: Morrison KE, Colón-González FJ, Morbey RA, et al. Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services. BMJ Open 2020;10:e038356. DOI: 10.1136/bmjopen-2020-038356

PY - 2020/11/6

Y1 - 2020/11/6

N2 - Objective: This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient's age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions. Design: Ecological study. Setting: Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH). Participants: 13 million respiratory contacts to NHS111, GPIH and GPOOH. Outcome measures: Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH. Results: More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15-44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar. Conclusion: When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour.

AB - Objective: This study will analyse respiratory contacts to three healthcare services that capture more of the community disease burden than acute data sources, such as hospitalisations. The objective is to explore associations between contacts to these services and the patient's age, gender and deprivation. Results will be compared between healthcare services, and with non-respiratory contacts to explore how contacts differ by service and illness. It is crucial to investigate the sociodemographic patterns in healthcare-seeking behaviour to enable targeted public health interventions. Design: Ecological study. Setting: Surveillance of respiratory contacts to three healthcare services in England: telehealth helpline (NHS111); general practitioner in-hours (GPIH); and general practitioner out of hours unscheduled care (GPOOH). Participants: 13 million respiratory contacts to NHS111, GPIH and GPOOH. Outcome measures: Respiratory contacts to NHS111, GPIH and GPOOH, and non-respiratory contacts to NHS111 and GPOOH. Results: More respiratory contacts were observed for females, with 1.59, 1.73, and 1.95 times the rate of contacts to NHS111, GPOOH and GPIH, respectively. When compared with 15-44 year olds, there were 37.32, 18.66 and 6.21 times the rate of respiratory contacts to NHS111, GPOOH and GPIH in children <1 year. There were 1.75 and 2.70 times the rate of respiratory contacts in the most deprived areas compared with the least deprived to NHS111 and GPOOH. Elevated respiratory contacts were observed for males <5 years compared with females <5 years. Healthcare-seeking behaviours between respiratory and non-respiratory contacts were similar. Conclusion: When contacts to services that capture more of the disease burden are explored, the demographic patterns are similar to those described in the literature for acute systems. Comparable results were observed between respiratory and non-respiratory contacts suggesting that when a wider spectrum of disease is explored, sociodemographic factors may be the strongest influencers of healthcare-seeking behaviour.

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KW - respiratory infections

KW - statistics & research methods

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DO - 10.1136/bmjopen-2020-038356

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SN - 2044-6055

VL - 10

JO - BMJ Open

JF - BMJ Open

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M1 - e038356

ER -

Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: A comparison with non-respiratory symptoms and between three healthcare services

Abstract

Bibliographical note

Keywords

UN SDGs

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