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首页> 外文期刊>International Journal of Population Data Science >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
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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

机译：使用关联的队列和基层医疗记录分析威尔士出生后前14年与改变全科医生习惯相关的因素：使用基层医疗数据库进行生命历程研究的意义

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IntroductionPrimary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing practices has received little attention. We investigated factors associated with changes in registration and record continuity in the Secure Anonymised Information Linkage (SAIL) databank, with ~80% practice coverage. Objectives and ApproachWe analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study (MCS) participants, resident in Wales and with parental consent to health record linkage at the age seven MCS interview. We studied time from first to next general practice (GP) registration in Wales by fitting Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for the following factors: child (sex, ethnicity, mode of delivery, gestation, birthweight, neonatal illness, wheeze, longstanding illness); maternal (age, education, lone parent status); household (income, housing tenure, residential mobility, urban/rural residence); GP type (SAIL-contributing/-non-contributing). Analyses were weighted for survey design (Stata: Release 15; StataCorp LP). ResultsThere were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% of children changed GP at least once, with 1070 (58.3%), 477 (26.0%) and 287 (15.7%) registered with 1, 2, 3+ GPs respectively up to 14 years of age. Children with older mothers (aHRs; 95% CI: 0.96; 0.95, 0.98; per year) or those residing in rural areas (0.75;0.56,0.99) were less likely, and those whose first registration was not with a SAIL contributing GP (2.16;1.60,2.93), whose mothers had no educational qualifications (1.40;1.15,1.71), or had recently changed address (1.62;1.21,2.16) more likely, to change GP. 305 (16.6%) children had never registered with a SAIL-contributing GP. Of 403 children initially registered with a SAIL contributing GP who then changed GP, 66.7% re-registered with a SAIL contributing GP. Conclusion/ImplicationsGeographically contiguous primary care databanks, such as the SAIL databank, enable a high proportion of children to be reliably followed over time despite changing GP. Similar analyses of databases based on geographically disparate volunteer GPs are needed to quality assure their suitability for life course epidemiology research.
机译：简介初级保健电子健康记录（pcEHRs）是生命过程研究的宝贵资源，但是由于实践改变而导致的随访损失很少受到关注。我们调查了与安全性匿名信息链接（SAIL）数据库中的注册更改和记录连续性相关的因素，实际覆盖率约为80％。目的和方法我们分析了1834名（882名女孩）千年队列研究（MCS）参与者的链接pcEHR，这些参与者均居住在威尔士，并在七岁的MCS访谈中得到父母的同意与健康记录挂钩。我们通过拟合Cox比例风险模型研究了威尔士首次至下一次普通科医师注册的时间，并针对以下因素估算了相互调整的风险比（aHR）：儿童（性别，种族，分娩方式，妊娠，出生体重） ，新生儿疾病，喘息，长期疾病）;孕产妇（年龄，教育程度，单亲身份）;家庭（收入，住房使用权，住房流动性，城市/农村居民）; GP类型（SAIL贡献/非贡献）。对调查的设计进行加权分析（Stata：第15版; StataCorp LP）。结果共有1 834名儿童的3065威尔士GP注册。到5岁时，有25％的孩子至少一次改变过GP，其中1070岁（58.3％），477（26.0％）和287（15.7％）岁的孩子分别向14岁以下的1，2，3+ GP注册。母亲年龄较大的孩子（aHRs; 95％CI：0.96; 0.95，0.98;每年）或居住在农村地区的孩子（0.75; 0.56,0.99）的可能性较小，而初次注册时未在SAIL贡献GP的孩子（ 2.16; 1.60,2.93）的母亲没有教育资格（1.40; 1.15,1.71），或者最近更可能更改地址（1.62; 1.21,2.16）来更改全科医生。 305名（16.6％）儿童从未向SAIL捐款全科医生注册。最初在SAIL供款GP中注册的403名儿童中，有66.7％的人在SAIL供款GP中重新注册。结论/意义尽管改变了全科医生，但地理上连续的初级保健数据库（例如SAIL数据库）使得随着时间的推移，仍能可靠地跟踪很大一部分儿童。需要基于地理上不同的志愿者GP进行数据库的类似分析，以确保其适用于生命周期流行病学研究。

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