Using Linked Primary and Secondary Care Data to Explore Complex Pathways Through Complex Systems for Patients with Long-Term Conditions

Date of Approval
Application Number
Technical Summary

The proposed study will examine methodological issues in using linked primary (CPRD) and secondary care data (HES) for describing variation in patterns of NHS care for patients with one or more of nine long-term conditions. Diagnosis of the LTCs from the different data sources will be made using established coding methods to examine consistency between CPRD and HES and identify patient and organisational factors associated with inconsistent records. Longitudinal records of NHS care utilisation will be created in order to describe and examine variation in the utilisation of different types of care (GP appointments, hospital outpatient attendances and hospital admissions) for cohorts of patients with the long-term conditions. The study will examine potential methodological issues in using linked data for this purpose by assessing, as far as is possible, the consistency and completeness of utilisation data and the way that utilisation varies depending on how cohorts are identified.


Jan van der Meulen - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Andrew Hutchings - Corresponding Applicant - London School of Hygiene & Tropical Medicine ( LSHTM )
John Robson - Collaborator - Queen Mary University of London
Kambiz Boomla - Collaborator - Barts and the London Queen Mary's School of Medicine and Dentistry
Spiros Denaxas - Collaborator - University College London ( UCL )


HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation