Completeness of EHR record
The primary care data documentation (https://biobank.ndph.ox.ac.uk/showcase/refer.cgi?id=591), describes that GPs are the first point of contact with the medical system, and that they may refer to specialty care “to hospital or other community-based services.”
The hospitalization inpatient data documentation (https://biobank.ndph.ox.ac.uk/showcase/refer.cgi?id=138483), describes that the data are limited to inpatients, and defines them as “patients who are admitted to the hospital and occupy a bed.” Although, “Not every participant will have a hospital inpatient record, as not all have been admitted to hospital within the period covered”, we found about 90% of UKB participants had an observation in the `hesin` hospitalization data (using the record-level access dataset). Based on the descriptions of what data are included in hospitalizations (i.e. ”patients who are admitted to the hospital and occupy a bed”), we would not expect the hospitalization rate to be so high.
Our concern is with participants receiving specialty care outside of a hospital. If a GP refers a patient to specialty care in a community-based service (e.g. a specialty clinic that is not part of a hospital), would a record of their specialty care encounter be recorded in the hospitalization data, in the primary care data, or not at all?
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Hi Peter,
The hospitalisation rate being high can be interpreted given it is an ageing population and the burden of disease increases with age. In addition, hospital inpatient records include maternity related hospitalisations, which can be another reason the percentage is so high.
It is possible some information from community based specialist services is captured in the GP data. Sometimes GPs receive medical letters from specialists and it's possible they record diagnosis information from these letters, which then ends up in the primary care records. However, please note that only a subset of the cohort (~45%) have primary care records.
Unfortunately, at the moment, we do not have records from outpatient hospital appointments or specialty care received outside of a hospital.
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