Stafford, M;
Deeny, SR;
Dreyer, K;
Shand, J;
(2021)
Multiple long-term conditions within households and use of health and social care: a retrospective cohort study.
BJGP Open
, 5
(2)
, Article 2 BJGPO.2020.0134. 10.3399/BJGPO.2020.0134.
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Abstract
Background: The daily management of long-term conditions falls primarily on individuals and informal carers, but the impact of household context on health and social care activity among people with multiple long-term conditions (MLTCs) is understudied. Aim: To test whether co-residence with a person with MLTCs (compared with a co-resident without MLTCs) is associated with utilisation and cost of primary, community, secondary health care, and formal social care. Design & setting: Linked data from health providers and local government in Barking and Dagenham for a retrospective cohort of people aged ≥50 years in two-person households in 2016–2018. Method: Two-part regression models were applied to estimate annualised use and cost of hospital, primary, community, mental health, and social care by MLTC status of individuals and co-residents, adjusted for age, sex, and deprivation. Applicability at the national level was tested using the Clinical Practice Research Datalink (CPRD). Results: Forty-eight per cent of people with MLTCs in two-person households were co-resident with another person with MLTCs. They were 1.14 (95% confidence interval [CI] = 1.00 to 1.30) times as likely to have community care activity and 1.24 (95% CI = 0.99 to 1.54) times as likely to have mental health care activity compared with those co-resident with a healthy person. They had more primary care visits (8.5 [95% CI = 8.2 to 8.8] versus 7.9 [95% CI = 7.7 to 8.2]) and higher primary care costs. Outpatient care and elective admissions did not differ. Findings in national data were similar. Conclusion: Care utilisation for people with MLTCs varies by household context. There may be potential for connecting health and community service input across household members.
| Type: | Article |
|---|---|
| Title: | Multiple long-term conditions within households and use of health and social care: a retrospective cohort study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3399/BJGPO.2020.0134 |
| Publisher version: | https://doi.org/10.3399/BJGPO.2020.0134 |
| Language: | English |
| Additional information: | Copyright © 2021, The Authors This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/) |
| Keywords: | comorbidity, inequalities, multimorbidity, multiple conditions, social context, socioeconomic factors |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10176296 |
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