Consistency, completeness and external validity of ethnicity recording in NHS primary care records: a cohort study in 25 million patients' records at source using OpenSAFELY.

Autor: Andrews CD; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK. colm.andrews@phc.ox.ac.uk., Mathur R; London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Wolfson Institute for Population Health, University of London, London, Queen Mary, E1 2AT, UK., Massey J; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Park R; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Curtis HJ; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Hopcroft L; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Mehrkar A; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Bacon S; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Hickman G; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Smith R; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Evans D; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Ward T; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Davy S; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Inglesby P; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Dillingham I; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Maude S; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., O'Dwyer T; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Butler-Cole BFC; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Bridges L; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Bates C; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK., Parry J; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK., Hester F; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK., Harper S; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK., Cockburn J; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK., Goldacre B; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., MacKenna B; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Tomlinson LA; London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Walker AJ; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK., Hulme WJ; Nuffield Department of Primary Care Health Sciences, Bennett Institute for Applied Data Science, Oxford University, Oxford, OX2 6GG, UK.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2024 Jul 10; Vol. 22 (1), pp. 288. Date of Electronic Publication: 2024 Jul 10.
DOI: 10.1186/s12916-024-03499-5
Abstrakt: Background: Ethnicity is known to be an important correlate of health outcomes, particularly during the COVID-19 pandemic, where some ethnic groups were shown to be at higher risk of infection and adverse outcomes. The recording of patients' ethnic groups in primary care can support research and efforts to achieve equity in service provision and outcomes; however, the coding of ethnicity is known to present complex challenges. We therefore set out to describe ethnicity coding in detail with a view to supporting the use of this data in a wide range of settings, as part of wider efforts to robustly describe and define methods of using administrative data.
Methods: We describe the completeness and consistency of primary care ethnicity recording in the OpenSAFELY-TPP database, containing linked primary care and hospital records in > 25 million patients in England. We also compared the ethnic breakdown in OpenSAFELY-TPP with that of the 2021 UK census.
Results: 78.2% of patients registered in OpenSAFELY-TPP on 1 January 2022 had their ethnicity recorded in primary care records, rising to 92.5% when supplemented with hospital data. The completeness of ethnicity recording was higher for women than for men. The rate of primary care ethnicity recording ranged from 77% in the South East of England to 82.2% in the West Midlands. Ethnicity recording rates were higher in patients with chronic or other serious health conditions. For each of the five broad ethnicity groups, primary care recorded ethnicity was within 2.9 percentage points of the population rate as recorded in the 2021 Census for England as a whole. For patients with multiple ethnicity records, 98.7% of the latest recorded ethnicities matched the most frequently coded ethnicity. Patients whose latest recorded ethnicity was categorised as Other were most likely to have a discordant ethnicity recording (32.2%).
Conclusions: Primary care ethnicity data in OpenSAFELY is present for over three quarters of all patients, and combined with data from other sources can achieve a high level of completeness. The overall distribution of ethnicities across all English OpenSAFELY-TPP practices was similar to the 2021 Census, with some regional variation. This report identifies the best available codelist for use in OpenSAFELY and similar electronic health record data.
(© 2024. The Author(s).)
Databáze: MEDLINE
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