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Using linked medical records to explore outcomes for people with mental illness By Uy Hoang
Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages of using the UHCE datasets for outcomes research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages of using the UHCE datasets for outcomes research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Research Questions ,[object Object],[object Object]
 
8,530 (98.2%) 157 (1.8%) 8,687 135,213 2003 8,112 (98.3%) 140 (1.7%) 8,252 137,402 2002 7,959 (98.2%) 148 (1.8%) 8,107 140,154 2001 7,707 (98.2%) 145 (1.8%) 7,852 145,138 2000 8,047 (98.2%) 148 (1.8%) 8,195 118,661 1999 Number of deaths within 365 days from natural causes (% of all deaths) Number of deaths within 365 days from unnatural causes (% of all deaths) Number of deaths within 365 days from all causes Number of people discharged Year
[object Object],[object Object],[object Object],[object Object]
Results 7,932 7,994 9,626 6,422 1,476 Northamptonshire 8,333 8,178 10,109 9,644 7,767 Buckinghamshire 8,943 10,222 11,935 8,360 6,402 Berkshire 7,209 7,417 7,922 10,399 9,810 Oxfordshire 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83 County
 
53.5/ 43.1 34/ 31.8 88.4/ 89.5 119.3/114.5 158/ 134.8 Average length of stay (LOS) in psychiatric care  Males/ Females (days) 37.5/ 40 39.2/ 42.8 47.6/ 52.3 49.1/ 54.4 45.8/ 50.6 Average age on admission (Males/Females) 6700/ 6178 (47.8%) 5622/ 5967 (51.6%) 7641/ 9187 (54.6%) 6566/ 8827 (57.3%) 5042/ 6546 (56.5%) Males/Females (%) 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83
-130.2 0.98 321.16 (183.66-521.49) 484.52 (369.77-623.66) 619.04 (547.3-690.79) 763.59 (683.25-843.93) 832.60 (719.72-945.48) 65+ yrs -99.15 0.96 42.54 (21.23-76.11) 60.64 (31.33-105.92) 189.87 (139.99-251.73) 331.76 (262.68-413.49) 402.74 (324.27-494.48) 45 – 64 yrs -15.34 0.83 32.77 (19.42-51.79) 22.09 (10.6-40.62) 58.49 (39.46-83.5) 60.72 (39.65-88.98) 90.14 (61.24-127.94) 15 – 44 yrs Female -152.1 0.98 481.91 (302.07-729.65) 684.30 (501.3-912.8) 835.13 (729.91-940.35) 1011.78 (887.84-1135.72) 1078.46 (897.87-1259.05) 65+ yrs -91.98 0.85 135.04 (89.75-195.18) 61.27 (28.05-116.27) 227.01 (162.2-309.14) 353.64 (269.88-455.19) 448.77 (347.77-569.94) 45 – 64 yrs -28.52 0.92 47.00 (31.71-67.1) 42.94 (26.58-65.64) 82.54 (59.74-111.18) 116.81 (86.7-154) 152.68 (114.36-199.72) 15 – 44 yrs B 1 R 2 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83 Mortality rate, 1 – 28 days post-hospital discharge (per 1,000 person-years at risk) Male
 
 
 
 
-1.81 0.72 5.00 (0.60-18.04) 9.48 (3.8-19.52) 7.41 (4.53-11.45) 9.23 (5.92-13.74) 14.19 (8.67-21.92) 65+ yrs -4.63 0.72 5.45 (2.82-9.52) 2.25 (0.61-5.75) 6.50 (3.55-10.91) 10.72 (6.72-16.24) 24.35 (17.83-32.48) 45 – 64 yrs -2.28 0.83 3.64 (2.08-5.92) 1.55 (0.57-3.37) 6.97 (4.7-9.95) 8.29 (5.55-11.91) 11.69 (8.1-16.34) 15 – 44 yrs Female -4.03 0.84 3.86 (0.12-21.50) 10.46 (2.85-26.77) 12.89 (7.64-20.37) 12.06 (6.59-20.23) 23.19 (12.99-38.24) 65+ yrs -3.82 0.48 8.19 (4.59-13.51) 4.33 (1.59-9.44) 16.00 (10.45-23.45) 27.05 (19.32-36.83) 15.92 (9.85-24.33) 45 – 64 yrs -2.30 0.46 10.07 (7.52-13.21) 2.70 (1.35-4.82) 10.53 (7.68-14.09) 16.51 (12.36-21.59) 14.66 (10.47-19.96) 15 – 44 yrs B 1 R 2 1999 – 2003 1994 – 98 1989 – 93 1984 – 88 1979 – 83 Mortality rate, 29 – 365 days post-hospital discharge (per 1,000 person years at risk) Male
 
286.2 (284.9 - 287.5) 428.3 (426.7 - 429.9) 65 years + 276.7 (276.1 - 277.3) 286.1 (285.5 - 286.7) <65 Admission rate to the specialty of psychiatry, per 100,000 population Admission rate for mental illness regardless of speciality, per 100,000 population Age
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenge of working with encrypted data ,[object Object],99.9 2008 96.8 2007 96.5 2006 95.9 2005 95.6 2004 93.9 2003 90.9 2002 87.2 2001 84.3 2000 81.3 1999 75.3 1998 % of hospital records with NHS number Year
 
 
Conclusions and further work ,[object Object],[object Object],[object Object]
Thank you ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Oxford Record Linkage Study

  • 1. Using linked medical records to explore outcomes for people with mental illness By Uy Hoang
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.  
  • 7. 8,530 (98.2%) 157 (1.8%) 8,687 135,213 2003 8,112 (98.3%) 140 (1.7%) 8,252 137,402 2002 7,959 (98.2%) 148 (1.8%) 8,107 140,154 2001 7,707 (98.2%) 145 (1.8%) 7,852 145,138 2000 8,047 (98.2%) 148 (1.8%) 8,195 118,661 1999 Number of deaths within 365 days from natural causes (% of all deaths) Number of deaths within 365 days from unnatural causes (% of all deaths) Number of deaths within 365 days from all causes Number of people discharged Year
  • 8.
  • 9. Results 7,932 7,994 9,626 6,422 1,476 Northamptonshire 8,333 8,178 10,109 9,644 7,767 Buckinghamshire 8,943 10,222 11,935 8,360 6,402 Berkshire 7,209 7,417 7,922 10,399 9,810 Oxfordshire 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83 County
  • 10.  
  • 11. 53.5/ 43.1 34/ 31.8 88.4/ 89.5 119.3/114.5 158/ 134.8 Average length of stay (LOS) in psychiatric care Males/ Females (days) 37.5/ 40 39.2/ 42.8 47.6/ 52.3 49.1/ 54.4 45.8/ 50.6 Average age on admission (Males/Females) 6700/ 6178 (47.8%) 5622/ 5967 (51.6%) 7641/ 9187 (54.6%) 6566/ 8827 (57.3%) 5042/ 6546 (56.5%) Males/Females (%) 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83
  • 12. -130.2 0.98 321.16 (183.66-521.49) 484.52 (369.77-623.66) 619.04 (547.3-690.79) 763.59 (683.25-843.93) 832.60 (719.72-945.48) 65+ yrs -99.15 0.96 42.54 (21.23-76.11) 60.64 (31.33-105.92) 189.87 (139.99-251.73) 331.76 (262.68-413.49) 402.74 (324.27-494.48) 45 – 64 yrs -15.34 0.83 32.77 (19.42-51.79) 22.09 (10.6-40.62) 58.49 (39.46-83.5) 60.72 (39.65-88.98) 90.14 (61.24-127.94) 15 – 44 yrs Female -152.1 0.98 481.91 (302.07-729.65) 684.30 (501.3-912.8) 835.13 (729.91-940.35) 1011.78 (887.84-1135.72) 1078.46 (897.87-1259.05) 65+ yrs -91.98 0.85 135.04 (89.75-195.18) 61.27 (28.05-116.27) 227.01 (162.2-309.14) 353.64 (269.88-455.19) 448.77 (347.77-569.94) 45 – 64 yrs -28.52 0.92 47.00 (31.71-67.1) 42.94 (26.58-65.64) 82.54 (59.74-111.18) 116.81 (86.7-154) 152.68 (114.36-199.72) 15 – 44 yrs B 1 R 2 1999 - 2003 1994 - 98 1989 - 93 1984 - 88 1979 - 83 Mortality rate, 1 – 28 days post-hospital discharge (per 1,000 person-years at risk) Male
  • 13.  
  • 14.  
  • 15.  
  • 16.  
  • 17. -1.81 0.72 5.00 (0.60-18.04) 9.48 (3.8-19.52) 7.41 (4.53-11.45) 9.23 (5.92-13.74) 14.19 (8.67-21.92) 65+ yrs -4.63 0.72 5.45 (2.82-9.52) 2.25 (0.61-5.75) 6.50 (3.55-10.91) 10.72 (6.72-16.24) 24.35 (17.83-32.48) 45 – 64 yrs -2.28 0.83 3.64 (2.08-5.92) 1.55 (0.57-3.37) 6.97 (4.7-9.95) 8.29 (5.55-11.91) 11.69 (8.1-16.34) 15 – 44 yrs Female -4.03 0.84 3.86 (0.12-21.50) 10.46 (2.85-26.77) 12.89 (7.64-20.37) 12.06 (6.59-20.23) 23.19 (12.99-38.24) 65+ yrs -3.82 0.48 8.19 (4.59-13.51) 4.33 (1.59-9.44) 16.00 (10.45-23.45) 27.05 (19.32-36.83) 15.92 (9.85-24.33) 45 – 64 yrs -2.30 0.46 10.07 (7.52-13.21) 2.70 (1.35-4.82) 10.53 (7.68-14.09) 16.51 (12.36-21.59) 14.66 (10.47-19.96) 15 – 44 yrs B 1 R 2 1999 – 2003 1994 – 98 1989 – 93 1984 – 88 1979 – 83 Mortality rate, 29 – 365 days post-hospital discharge (per 1,000 person years at risk) Male
  • 18.  
  • 19. 286.2 (284.9 - 287.5) 428.3 (426.7 - 429.9) 65 years + 276.7 (276.1 - 277.3) 286.1 (285.5 - 286.7) <65 Admission rate to the specialty of psychiatry, per 100,000 population Admission rate for mental illness regardless of speciality, per 100,000 population Age
  • 20.
  • 21.
  • 22.  
  • 23.  
  • 24.
  • 25.

Editor's Notes

  1. 553,500 person-years of follow-up, Records for 58,704 people aged 15 years and over, 166,100 admissions to hospital, 138,597 of which ended with discharge to non-residential care between 1st January 1979 and 31st December 2003