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  • 1 September 2022 to 31 August 2023
  • Project No: 588
  • Funding round: FR3

Recent estimates suggest that between 15 per cent and 30 per cent of the English population suffer from more than one medical condition, a problem known as multi-morbidity. The proportion of the English population with this problem is expected to grow further in the coming years. It is expensive for the NHS, because patients in this state of health take up more than half of GP consultations and hospital admissions and receive more than three-quarters of all prescriptions issued.

In February 2020, the Institute for Health Equity published the report “The Marmot review 10 years on”. It analysed trends in health inequalities in England in the last ten years and reported large differences in health by regional and socioeconomic status, and highlighted that these differences are growing. We know that multi-morbidity is more common amongst women, older people and people from deprived areas, but we know little about the inequalities in access to healthcare that exist amongst middle-aged and older people with multi-morbidity. Our research will attempt to fill this gap in our knowledge.

We will study:

1) Whether there is inequality in the use of health services between middle-aged and older people with multi-morbidity that live in poorer and wealthier areas.

2) Whether there is inequality in waiting times for health services between middle-aged and older people with multi-morbidity that live in poorer and wealthier areas.

3) Whether the COVID-19 pandemic has led to greater inequality in the use of health services and waiting times between middle-aged and older people with multi-morbidity that live in poorer and wealthier areas.

4) Whether the data used in this study is suitable to explore inequalities in socioeconomic indicators other than deprivation when studying the use of and access to health care by middle-aged and older people with multi-morbidity.

We will use two datasets to answer these questions, namely the Clinical Practice Research Datalink (CPRD), which collects information from GP practices, and Hospital Episode Statistics (HES), which contains data from hospitals. We will look at people aged 50 and over because multi-morbidity happens more in later life. We will analyse data covering the period April 2007 to March 2021.

The research team consists of primary care clinicians, economists, statisticians and a psychologist who have the skills required to carry out this research. We will also encourage patients to contribute by including them in an advisory group.

To connect with the government, we will use the networks that we have established through our previous work. To tell other researchers about our work we will present our results at conferences and seminars and submit papers to top economic and medical journals. We will also hold events to share our work with the general public, as well as through plain language summaries and short video clips.

Amount Awarded: £61,250

Projects by themes

We have grouped projects under the five SPCR themes in this document

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.