ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018
Population and patient factors affecting emergency department attendance in London: retrospective cohort analysis of linked primary and secondary care records.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Pooled it
- Cessation of smoking in people attending UK emergency departments: the COSTED RCT with economic and process evaluation.Health technology assessment (Winchester, England) · 2025Trial
- Shifting patterns in emergency department attendance: a time series analysis.Emergency medicine journal : EMJ · 2026Article
- Article
- Ascertaining cause-specific emergency department demand using forecast combinations.BMC emergency medicine · 2026Article
- Frequent Users of Emergency Departments: Analysis of the Characteristics and Geographical Distribution in a Local Health Authority in Rome, Italy.Healthcare (Basel, Switzerland) · 2025Article
- Identifying and Predicting Risk for Hospital Admission among Patients with Parkinsonism.Movement disorders clinical practice · 2025Article
- How predictive of future healthcare utilisation and mortality is data-driven population segmentation based on healthcare utilisation and chronic condition comorbidity?BMC public health · 2024Article
- Article
- Combinations of multiple long term conditions and risk of hospital admission or death during winter 2021-22 in England: population based cohort study.BMJ medicine · 2024Article
- Multimorbidity and adverse outcomes following emergency department attendance: population based cohort study.BMJ medicine · 2024Article
- Homelessness and Emergency Department Use: Wait Time Disparities Across Triage Acuity Levels.Cureus · 2023Article
- A multi-granular stacked regression for forecasting long-term demand in Emergency Departments.BMC medical informatics and decision making · 2023Article
- Factors Associated with Emergency Department Visits and Consequent Hospitalization and Death in Korea Using a Population-Based National Health Database.Healthcare (Basel, Switzerland) · 2022Article
- Article
- Article
- Article
- Prevalence of suspected COVID-19 infection in patients from ethnic minority populations: a cross-sectional study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Cancer diagnoses after emergency GP referral or A&E attendance in England: determinants and time trends in Routes to Diagnosis data, 2006-2015.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Predictors of late presentation to renal dialysis: a cohort study of linked primary and secondary care records in East London.BMJ open · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPopulation factors, including social deprivation and morbidity, predict the use of emergency departments (EDs).
aimTo link patient-level primary and secondary care data to determine whether the association between deprivation and ED attendance is explained by multimorbidity and other clinical factors in the GP record. DESIGN AND
settingRetrospective cohort study based in East London.
methodPrimary care demographic, consultation, diagnostic, and clinical data were linked with ED attendance data. GP Patient Survey (GPPS) access questions were linked to practices.
resultsAdjusted multilevel analysis for adults showed a progressive rise in ED attendance with increasing numbers of long-term conditions (LTCs). Comparing two LTCs with no conditions, the odds ratio (OR) is 1.28 (95% confidence interval [CI] = 1.25 to 1.31); comparing four or more conditions with no conditions, the OR is 2.55 (95% CI = 2.44 to 2.66). Increasing annual GP consultations predicted ED attendance: comparing zero with more than two consultations, the OR is 2.44 (95% CI = 2.40 to 2.48). Smoking (OR 1.30, 95% CI = 1.28 to 1.32), being housebound (OR 2.01, 95% CI = 1.86 to 2.18), and age also predicted attendance. Patient-reported access scores from the GPPS were not a significant predictor. For children, younger age, male sex, white ethnicity, and higher GP consultation rates predicted attendance.
conclusionUsing patient-level data rather than practice-level data, the authors demonstrate that the burden of multimorbidity is the strongest clinical predictor of ED attendance, which is independently associated with social deprivation. Low use of the GP surgery is associated with low attendance at ED. Unlike other studies, the authors found that adult patient experience of GP access, reported at practice level, did not predict use.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.