START DATE AND DURATION: September 2020This study is evaluating existing service models for older patients across diverse settings for a range of outcomes. It will adopt comparable approaches using realist evaluation, incorporating mainly quantitative data (and some qualitative data) leading to an economic evaluation.
The study is undertaking health services evaluation in a uniquely integrated dataset offered by the Delirium and Population Health Informatics Cohort (DELPHIC) - a cohort of 1500 active patients over 70 years old. This will look at the same individuals across primary, secondary, mental health and social care.
We are also using data from this cohort to better understand the transmission and prognosis of COVID-19 in older people. We are using the data to ascertain weekly symptoms (for diagnosis), acquire samples and to follow COVID-19 cases as their illness evolves. Data and clinical samples have been collected to identify immunological pathways underlying differences in elderly peoples’ response to the virus. This part of the work is funded by the Medical Research Council (MRC), Wellcome Trust, Rosetrees Trust and the NIHR UCLH Biomedical Research Centre (BRC).
An additional study using the Care City Cohort – a cohort of residents of Barking and Dagenham comprising data linked across primary, secondary, community, mental health and social care, demonstrates that acute hospital admissions in older adults are associated with increased long-term service use, especially in patients with higher levels of multimorbidity. This leads to elevated service use and costs in all care settings, particularly in social care, long after the acute illness period. Together, these findings may help with integrated and coordinated service design, both in whole populations, and in subgroups.
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