Imperial College London
Alternate

Alex Bottle

Faculty of Medicine, School of Public Health

Professor of Medical Statistics
 
 
 
//

Contact

 

+44 (0)20 7594 0913robert.bottle Website

 
 
//

Location

 

3 Dorset Rise, London EC4Y 8ENCharing Cross HospitalCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Kim:2020:10.3399/bjgp20X711749,
author = {Kim, D and Hayhoe, B and Aylin, P and Cowie, M and Bottle, R},
doi = {10.3399/bjgp20X711749},
journal = {British Journal of General Practice},
pages = {e563--e572},
title = {Health service use by patients with heart failure living in a community setting: a cross-sectional analysis in North West London},
url = {http://dx.doi.org/10.3399/bjgp20X711749},
volume = {70},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:   The   complex   nature   of   heart   failure   (HF)   management,   often   involving multidimensional  care,  is  widely  recognised,  but  overall  health  service  utilisation  by  HF patients has not previously been described.Aim: To describe overall health service use by community-dwelling adults with HF.Design  and  Setting:  Cross-sectional  analysis  of  prevalent  HF  cases  between  2015  and  2018 using   an   administrative   dataset   covering   primary   care,   secondary   care,   and   ‘other’ (community, mental health, and social care) services in North West London (NWL).Methods: Healthcare use of each service was described overall and by individual components of secondary care (e.g. outpatient appointments) and ‘other’ services (e.g. nursing contacts). Usage patterns were identified using k-means cluster analysis using all distinct contacts for the whole study period and visualised by a heatmap.  Results: There were 39 301 patients with a prevalent diagnosis of HF between 1 January 2015 and 31 December 2018. 90% used health services during the study period, most commonly outpatient services, GP consultations, unplanned A&E visits and community services. Use of cardiology-specific services ranged from around 3% (cardiology-related community care) to around 20% (outpatient cardiology visits). GP consultations decreased by 11% over our study period. Five clusters of patients were identified, each with significantly different care usage patterns and patient characteristics.Conclusions: HF patients make heavy but heterogeneous use of services. Relatively low and falling  use  of  GP  consultations,  and  apparently  low  uptake  of  community  rehabilitation services by patients with HF, is concerning and suggests challenges in primary care access and integration of care.
AU  - Kim,D
AU  - Hayhoe,B
AU  - Aylin,P
AU  - Cowie,M
AU  - Bottle,R
DO  - 10.3399/bjgp20X711749
EP  - 572
PY  - 2020///
SN  - 0960-1643
SP  - 563
TI  - Health service use by patients with heart failure living in a community setting: a cross-sectional analysis in North West London
T2  - British Journal of General Practice
UR  - http://dx.doi.org/10.3399/bjgp20X711749
UR  - https://bjgp.org/content/70/697/e563
UR  - http://hdl.handle.net/10044/1/78583
VL  - 70
ER  -
Download