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Social patterning of telephone health-advice for diarrhoea and vomiting: analysis of 24 million telehealth calls in England

Lookup NU author(s): Professor Sarah O'Brien



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


OBJECTIVES: Gastrointestinal (GI) infections are common and most people do not see a physician. There is conflicting evidence of the impact of socioeconomic status (SES) on risk of GI infections. We assessed the relationship between SES and GI calls to two National Health Service (NHS) telephone advice services in England.METHODS: Over 24 million calls to NHS Direct (2010-13) and NHS 111 (2013-15) were extracted from Public Health England (PHE) syndromic surveillance systems. The relationship between SES and GI calls was assessed using generalised linear models (GLM).RESULTS: Adjusting for rurality and age-sex interactions, in NHS Direct, children in disadvantaged areas were at lower risk of GI calls; in NHS 111 there was a higher risk of GI calls in disadvantaged areas for all ages (0-4 years RR 1.27, 95% CI 1.25-1.29; 5-9 years RR 1.43, 95% CI 1.36-1.51; 10-14 years RR 1.36, 95% CI 1.26-1.41; 15-19 years RR 1.59, 95% CI 1.52-1.67; 20-59 years RR 1.50, 95% CI 1.47-1.53, 60 years and over RR 1.12, 95% CI 1.09-1.14).CONCLUSIONS: Disadvantaged areas had higher risk of GI calls in NHS 111. This may relate to differences in exposure or vulnerability to GI infections, or propensity to call about GI infections.

Publication metadata

Author(s): Adams NL, Rose TC, Elliot AJ, Smith G, Morbey R, Loveridge P, Lewis J, Studdard G, Violato M, O'Brien SJ, Whitehead M, Taylor-Robinson DC, Hawker JI, Barr B

Publication type: Article

Publication status: Published

Journal: Journal of Infection

Year: 2019

Volume: 78

Issue: 2

Pages: 95-100

Print publication date: 01/02/2019

Online publication date: 26/09/2018

Acceptance date: 18/09/2018

Date deposited: 08/08/2019

ISSN (print): 0163-4453

ISSN (electronic): 1532-2742

Publisher: W.B. Saunders Co. Ltd


DOI: 10.1016/j.jinf.2018.09.008

PubMed id: 30267800


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Funder referenceFunder name
NIHR HPRU 201210,038