Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research
Background Databanks of primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing general practice has received little attention. Objective We investigated factors associated with changing general practice (GP) in...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Swansea University
2018-06-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/477 |
| _version_ | 1797427979723210752 |
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| author | Carol Dezateux Lucy J Griffiths Bianca L De Stavola Ashley Akbari Amrita Bandyopadhyay Karen S Tingay Mario Cortina-Borja Helen Bedford Ronan A Lyons |
| author_facet | Carol Dezateux Lucy J Griffiths Bianca L De Stavola Ashley Akbari Amrita Bandyopadhyay Karen S Tingay Mario Cortina-Borja Helen Bedford Ronan A Lyons |
| author_sort | Carol Dezateux |
| collection | DOAJ |
| description | Background
Databanks of primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing general practice has received little attention.
Objective
We investigated factors associated with changing general practice (GP) in early life and continuity of participation in the Secure Anonymised Information Linkage (SAIL) databank, to which approximately 80% of Welsh practices contribute.
Methods
We analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study participants, resident in Wales, with consent to health record linkage. We studied time from first to next practice registration using Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for child, household and practice factors.
Findings
There were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% changed practice at least once, with 1070 (58.3%), 477 (26.0%), 287 (15.7%) registered with 1, 2, or 3+ GPs respectively by age 14 years. Changing practice was related to maternal age (aHRs; 95% CI: 0.96; 0.95,0.98), living in rural areas (0.75;0.56,0.99), initial registration with a non-SAIL-practice (2.16;1.60,2.93), recent address change (1.62;1.21,2.16), and no maternal educational qualifications (1.40;1.15,1.71). Overall, 305 (16.6%) children had never registered with a SAIL practice. Of 403 children initially registered with a SAIL practice who then changed practice, 66.7% re-registered with a SAIL practice.
Conclusions
In a nationally representative sample of Welsh children, the majority remained registered with the same practice up to age 14 years, with change in practice varying by maternal and household factors. Continuity of participation in the Welsh SAIL databank over early life is high, reflecting the high proportion of practices contributing, and the high proportion of children registered with them. Geographically contiguous primary care databanks, such as SAIL, enable a high proportion of children to be followed over time despite changing general practice. |
| first_indexed | 2024-03-09T08:52:37Z |
| format | Article |
| id | doaj.art-da66a686868e4f4aae06bb03ad42610a |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T08:52:37Z |
| publishDate | 2018-06-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-da66a686868e4f4aae06bb03ad42610a2023-12-02T14:01:00ZengSwansea UniversityInternational Journal of Population Data Science2399-49082018-06-013210.23889/ijpds.v3i2.477477Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course researchCarol Dezateux0Lucy J Griffiths1Bianca L De Stavola2Ashley Akbari3Amrita Bandyopadhyay4Karen S Tingay5Mario Cortina-Borja6Helen Bedford7Ronan A Lyons8Centre for Primary Care and Public Health, Queen Mary University London, London, UKGreat Ormond Street Institute of Child Health, University College London, London, UKGreat Ormond Street Institute of Child Health, University College London, London, UKFarr Institute, Swansea University Medical School, Swansea, UKSwansea University Medical School, Swansea, UKADRC-W, Swansea University Medical School, Swansea, UKGreat Ormond Street Institute of Child Health, University College London, London, UKGreat Ormond Street Institute of Child Health, University College London, London, UKFarr Institute, Swansea University Medical School, Swansea, UKBackground Databanks of primary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing general practice has received little attention. Objective We investigated factors associated with changing general practice (GP) in early life and continuity of participation in the Secure Anonymised Information Linkage (SAIL) databank, to which approximately 80% of Welsh practices contribute. Methods We analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study participants, resident in Wales, with consent to health record linkage. We studied time from first to next practice registration using Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for child, household and practice factors. Findings There were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% changed practice at least once, with 1070 (58.3%), 477 (26.0%), 287 (15.7%) registered with 1, 2, or 3+ GPs respectively by age 14 years. Changing practice was related to maternal age (aHRs; 95% CI: 0.96; 0.95,0.98), living in rural areas (0.75;0.56,0.99), initial registration with a non-SAIL-practice (2.16;1.60,2.93), recent address change (1.62;1.21,2.16), and no maternal educational qualifications (1.40;1.15,1.71). Overall, 305 (16.6%) children had never registered with a SAIL practice. Of 403 children initially registered with a SAIL practice who then changed practice, 66.7% re-registered with a SAIL practice. Conclusions In a nationally representative sample of Welsh children, the majority remained registered with the same practice up to age 14 years, with change in practice varying by maternal and household factors. Continuity of participation in the Welsh SAIL databank over early life is high, reflecting the high proportion of practices contributing, and the high proportion of children registered with them. Geographically contiguous primary care databanks, such as SAIL, enable a high proportion of children to be followed over time despite changing general practice.https://ijpds.org/article/view/477 |
| spellingShingle | Carol Dezateux Lucy J Griffiths Bianca L De Stavola Ashley Akbari Amrita Bandyopadhyay Karen S Tingay Mario Cortina-Borja Helen Bedford Ronan A Lyons Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research International Journal of Population Data Science |
| title | Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research |
| title_full | Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research |
| title_fullStr | Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research |
| title_full_unstemmed | Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research |
| title_short | Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life-course research |
| title_sort | analysis of factors associated with changing general practice in the first 14 years of life in wales using linked cohort and primary care records implications for using primary care databanks for life course research |
| url | https://ijpds.org/article/view/477 |
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