Teoh, Lucinda Jade;
(2024)
Secondary healthcare care use and health outcomes of children with eye and vision disorders in England.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Introduction: Ophthalmic disorders associated with vision loss during childhood are a heterogenous group of conditions ranging from rare to common, that collectively have a significant impact on the development and quality of life of children and young people. Currently our understanding of the levels and patterns of secondary care use and mortality in children with eye and vision disorders, particularly the involvement of socioeconomic deprivation is lacking.// Methods: To address this, I explored Hospital Episodes Statistics to examine how useful this dataset is for examining childhood eye and vision disorders. A national longitudinal inception cohort of 11 ‘exemplar’ eye disorders was created using a clinically informed phenotyping algorithm. Linked inpatient, outpatient and ONS mortality records were used to examine the incidence, mortality rate in and risk factors associated with higher rates of secondary care use. // Results: Inpatient HES data is useful for examining paediatric eye disorders treated primarily during hospital admissions, however outpatient data are currently poorly coded and not fit for creating cohorts based on diagnosis or procedure codes. The key strength of HES as a large, national administrative dataset with patient level data, is particularly valuable in research of paediatric eye and vision disorders which are often cross-sectional. The significant socio-economic and ethnic disparities in mortality rates and secondary care use is an area for concern. Increasing rates of ophthalmic care use over time suggests that volume of paediatric ophthalmology clinical load will increase.// Conclusion: Healthcare utilisation data is important for the planning and commissioning of specialist NHS eye care services. Future work to explore and disentangle the reasons for differences in healthcare use in non-white children and those from the most deprived areas in England is needed to inform policies and interventions to reduce health inequalities.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Secondary healthcare care use and health outcomes of children with eye and vision disorders in England |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | 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 Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10187783 |
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