Dataset Information

Social patterning of telephone health-advice for diarrhoea and vomiting: analysis of 24 million telehealth calls in England.

ABSTRACT:

Objectives

Gastrointestinal (GI) infections are common and most people do not see a physician. There is conflicting evidence of the impact of socioeconomic status (SES) on risk of GI infections. We assessed the relationship between SES and GI calls to two National Health Service (NHS) telephone advice services in England.

Methods

Over 24 million calls to NHS Direct (2010-13) and NHS 111 (2013-15) were extracted from Public Health England (PHE) syndromic surveillance systems. The relationship between SES and GI calls was assessed using generalised linear models (GLM).

Results

Adjusting for rurality and age-sex interactions, in NHS Direct, children in disadvantaged areas were at lower risk of GI calls; in NHS 111 there was a higher risk of GI calls in disadvantaged areas for all ages (0-4 years RR 1.27, 95% CI 1.25-1.29; 5-9 years RR 1.43, 95% CI 1.36-1.51; 10-14 years RR 1.36, 95% CI 1.26-1.41; 15-19 years RR 1.59, 95% CI 1.52-1.67; 20-59 years RR 1.50, 95% CI 1.47-1.53, 60 years and over RR 1.12, 95% CI 1.09-1.14).

Conclusions

Disadvantaged areas had higher risk of GI calls in NHS 111. This may relate to differences in exposure or vulnerability to GI infections, or propensity to call about GI infections.

SUBMITTER: Adams NL

PROVIDER: S-EPMC6428660 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Social patterning of telephone health-advice for diarrhoea and vomiting: analysis of 24 million telehealth calls in England.

Adams Natalie L NL Rose Tanith C TC Elliot Alex J AJ Smith Gillian G Morbey Roger R Loveridge Paul P Lewis James J Studdard Gareth G Violato Mara M O'Brien Sarah J SJ Whitehead Margaret M Taylor-Robinson David C DC Hawker Jeremy I JI Barr Benjamin B

The Journal of infection 20180926 2

<h4>Objectives</h4>Gastrointestinal (GI) infections are common and most people do not see a physician. There is conflicting evidence of the impact of socioeconomic status (SES) on risk of GI infections. We assessed the relationship between SES and GI calls to two National Health Service (NHS) telephone advice services in England.<h4>Methods</h4>Over 24 million calls to NHS Direct (2010-13) and NHS 111 (2013-15) were extracted from Public Health England (PHE) syndromic surveillance systems. The r ...[more]

PMID: 30267800

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Project description:BACKGROUND:Recent studies have thoughtfully and convincingly demonstrated the possibility of estimating the circadian rhythms of young adults' social activity by analyzing their telephone call-detail records (CDRs). In the field of health monitoring, this development may offer new opportunities for supervising a patient's health status by collecting objective, unobtrusive data about their daily social interactions. However, before considering this future perspective, whether and how similar results could be observed in other populations, including older ones, should be established. OBJECTIVE:This study was designed specifically to address the circadian rhythms in the telephone calls of older adults. METHODS:A longitudinal, 12-month dataset combining CDRs and questionnaire data from 26 volunteers aged 65 years or older was used to examine individual differences in the daily rhythms of telephone call activity. The study used outgoing CDRs only and worked with three specific telecommunication parameters: (1) call recipient (alter), (2) time of day, and (3) call duration. As did the studies involving young adults, we analyzed three issues: (1) the existence of circadian rhythms in the telephone call activity of older adults, (2) their persistence over time, and (3) the alter-specificity of calls by calculating relative entropy. RESULTS:We discovered that older adults had their own specific circadian rhythms of outgoing telephone call activity whose salient features and preferences varied across individuals, from morning until night. We demonstrated that rhythms were consistent, as reflected by their persistence over time. Finally, results suggested that the circadian rhythms of outgoing telephone call activity were partly structured by how older adults allocated their communication time across their social network. CONCLUSIONS:Overall, these results are the first to have demonstrated the existence, persistence, and alter-specificity of the circadian rhythms of the outgoing telephone call activity of older adults. These findings suggest an opportunity to consider modern telephone technologies as potential sensors of daily activity. From a health care perspective, these sensors could be harnessed for unobtrusive monitoring purposes.

Project description:BackgroundA spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH.MethodsThis was a nested case-control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well.ResultsWe included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%.ConclusionHeadache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 ( www.clinicaltrials.gov ).

Dataset Information

Social patterning of telephone health-advice for diarrhoea and vomiting: analysis of 24 million telehealth calls in England.

Objectives

Methods

Results

Conclusions

Publications

Social patterning of telephone health-advice for diarrhoea and vomiting: analysis of 24 million telehealth calls in England.

Similar Datasets

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