Exploring healthcare pathways according to socioeconomic deprivation in populations with osteoarthritis: Applying sequence analysis to pre-arthroplasty pathways

PI Title: Dahai Yu

Lead member: Keele

This project aims to understand the difference in healthcare journeys in people with osteoarthritis before they undergo joint replacement surgery. Typically, healthcare journeys include the number of healthcare consultations a person may have, who they consult (for example, a general practitioner, nurse or physicians associate), what advice is given (for example, education on osteoarthritis or weight loss advice) and what management is received (for example, prescription for painkillers or referral to physiotherapy).

While clinical guidelines recommend various treatments, it remains unclear how or whether patients actually receive these treatments, in what order, and at what stage of their condition. In particular, it is not clear whether patients’ access to clinical care is different depending on their socioeconomic status.

By studying the real-world healthcare journeys of people with osteoarthritis leading up to total hip or knee replacement, we hope to gain valuable insights into early signs of disease progression and variations in care that may not be justified. The project consists of a series of studies that will utilise a method called "sequence analysis" to identify common patterns of healthcare use. While this method is frequently used to understand the life journeys of individuals, it has not been extensively employed to analyse healthcare journeys. To conduct this research, we will use data from the Clinical Practice Research Datalink, a large database containing anonymised electronic health records of thousands of patients in England & Wales. Specifically, we will focus on patients who have undergone hip or knee replacements and examine their healthcare interactions over the 10 years prior to total hip or knee replacement.

Through the process of simplifying this data into the most common types of healthcare pathways, our objective is to create an easily comprehensible format for patients, medical practitioners, and healthcare decision-makers in the format of a healthcare pathway. Additionally, these findings will enable us to compare patient journeys with established guidelines, providing insights into the degree of adherence. This comparison will help us identify potential areas for improvement, particularly if variations emerge based on socioeconomic groups.

We will investigate which groups of people tend to follow specific healthcare pathways. We will pay particular attention to factors such as age, sex, and comorbidities to understand how these variables may influence the types of care people with osteoarthritis receive. By examining these factors, we hope to shed light on any potential disparities in healthcare provision and identify areas for improvement in patient care. Our project is led by an experienced and dedicated team, fully committed to successfully completing this research. Through this study, we will enhance our understanding of the healthcare experiences of people with osteoarthritis and contribute to optimising care for those on a journey to joint replacement surgery.

Amount awarded:  £69,942