Prognostic factors and outcomes for medical emergency admissions. (360G-Wellcome-093564_Z_10_Z)

This project has been designed to determine the possible influence of a number of important structural factors on the often large variation in mortality rates across hospitals and how this may extend to other major outcome measures. For example, in very large tertiary care hospitals that concentrate on specialist surgery and care, there is particular interest as to whether outcomes may be affected for more routine common acute disorders that do not usually require complex treatment. We wil l investigate outcomes for 12 emergency conditions, including stroke, acute MI, COPD and hip fracture, using record linkage of electronic inpatient, mortality and primary care data for hospitals across England and Wales. Analyses of outcome measures will be adjusted, where appropriate for case mix; including patient demographics, postcode-based social deprivation and co-morbidities. The study builds on unique record linkage infrastructure in the Health Information Research Unit, School of Medic ine, Swansea University as well as a longstanding collaboration with the Unit of Health-Care Epidemiology, University of Oxford.