Dataset Information

Using an Ontology to Facilitate More Accurate Coding of Social Prescriptions Addressing Social Determinants of Health: Feasibility Study.

ABSTRACT:

Background

National Health Service (NHS) England supports social prescribing in order to address social determinants of health, which account for approximately 80% of all health outcomes. Nevertheless, data on ongoing social prescribing activities are lacking. Although NHS England has attempted to overcome this problem by recommending 3 standardized primary care codes, these codes do not capture the social prescribing activity to a level of granularity that would allow for fair attribution of outcomes to social prescribing.

Objective

In this study, we explored whether an alternative approach to coding social prescribing activity, specifically through a social prescribing ontology, can be used to capture the social prescriptions used in primary care in greater detail.

Methods

The social prescribing ontology, implemented according to the Web Ontology Language, was designed to cover several key concepts encompassing social determinants of health. Readv2 and Clinical Terms Version 3 codes were identified using the NHS Terms Browser. The Royal College of General Practitioners Research Surveillance Centre, a sentinel network of over 1000 primary care practices across England covering a population of more than 4,000,000 registered patients, was used for data analyses for a defined period (ie, January 2011 to December 2019).

Results

In all, 668 codes capturing social prescriptions addressing different social determinants of health were identified for the social prescribing ontology. For the study period, social prescribing ontology codes were used 5,504,037 times by primary care practices of the Royal College of General Practitioners Research Surveillance Centre as compared to 29,606 instances of use of social prescribing codes, including NHS England's recommended codes.

Conclusions

A social prescribing ontology provides a powerful alternative to the codes currently recommended by NHS England to capture detailed social prescribing activity in England. The more detailed information thus obtained will allow for explorations about whether outputs or outcomes of care delivery can be attributed to social prescriptions, which is essential for demonstrating the overall value that social prescribing can deliver to the NHS and health care systems.

SUBMITTER: Jani A

PROVIDER: S-EPMC7762682 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Using an Ontology to Facilitate More Accurate Coding of Social Prescriptions Addressing Social Determinants of Health: Feasibility Study.

Jani Anant A Liyanage Harshana H Okusi Cecilia C Sherlock Julian J Hoang Uy U Ferreira Filipa F Yonova Ivelina I de Lusignan Simon S

Journal of medical Internet research 20201211 12

<h4>Background</h4>National Health Service (NHS) England supports social prescribing in order to address social determinants of health, which account for approximately 80% of all health outcomes. Nevertheless, data on ongoing social prescribing activities are lacking. Although NHS England has attempted to overcome this problem by recommending 3 standardized primary care codes, these codes do not capture the social prescribing activity to a level of granularity that would allow for fair attributi ...[more]

PMID: 33306032

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Project description:PurposeSocial determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH.MethodsA team from the American Medical Association’s Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate.ResultsTwenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations.ConclusionDespite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multitude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional “preclinical” years, indicates curricular areas in need of attention.

Project description:BACKGROUND: In order to improve the health of the most vulnerable groups in society, the WHO Commission on Social Determinants of Health (CSDH) called for multi-sectoral action, which requires research and policy on the multiple and inter-linking factors shaping health outcomes. Most conceptual tools available to researchers tend to focus on singular and specific social determinants of health (SDH) (e.g. social capital, empowerment, social inclusion). However, a new and innovative conceptual framework, known as social quality theory, facilitates a more complex and complete understanding of the SDH, with its focus on four domains: social cohesion, social inclusion, social empowerment and socioeconomic security, all within the same conceptual framework. This paper provides both an overview of social quality theory in addition to findings from a national survey of social quality in Australia, as a means of demonstrating the operationalisation of the theory. METHODS: Data were collected using a national random postal survey of 1044 respondents in September, 2009. Multivariate logistic regression analysis was conducted. RESULTS: Statistical analysis revealed that people on lower incomes (less than $45000) experience worse social quality across all of the four domains: lower socio-economic security, lower levels of membership of organisations (lower social cohesion), higher levels of discrimination and less political action (lower social inclusion) and lower social empowerment. The findings were mixed in terms of age, with people over 65 years experiencing lower socio-economic security, but having higher levels of social cohesion, experiencing lower levels of discrimination (higher social inclusion) and engaging in more political action (higher social empowerment). In terms of gender, women had higher social cohesion than men, although also experienced more discrimination (lower social inclusion). CONCLUSIONS: Applying social quality theory allows researchers and policy makers to measure and respond to the multiple sources of oppression and advantage experienced by certain population groups, and to monitor the effectiveness of interventions over time.

Dataset Information

Using an Ontology to Facilitate More Accurate Coding of Social Prescriptions Addressing Social Determinants of Health: Feasibility Study.

Background

Objective

Methods

Results

Conclusions

Publications

Using an Ontology to Facilitate More Accurate Coding of Social Prescriptions Addressing Social Determinants of Health: Feasibility Study.

Similar Datasets

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