Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England

Severe ocular chemical injury in the UK: a British Ophthalmological Surveillance Unit study

BACKGROUND

Severe ocular chemical injury is a potentially devastating condition which most commonly affects men of working age. Workplace injuries previously accounted for the majority of incidents, but there has been a recent increase in assaults involving corrosive substances throughout the UK. The objectives of this study were to determine the incidence and demographics of severe ocular chemical injury and describe current surgical management practices.

METHODS

Cases were prospectively ascertained through the British Ophthalmological Surveillance Unit monthly reporting system during 2019-21. In total, 20 cases involving 29 eyes met the inclusion criteria.

RESULTS

The reported incidence of severe ocular chemical injury during the pre-pandemic period of the study was 0.24 per million. Cases due to alleged assault have become more common than workplace injuries. A total of 81% patients had persistent complications at 6 months requiring ongoing treatment, and 60% patients required surgical intervention.

CONCLUSION

Although there are limitations with the case ascertainment methods, severe ocular chemical injury remains rare within the UK. There has been a proportionate increase in cases related to alleged assault compared with previous similar studies. Amniotic membrane grafting remains the most commonly performed surgical procedure in these patients.

Trends in inequalities in avoidable hospitalisations across the COVID-19 pandemic: a cohort study of 23.5 million people in England

OBJECTIVE

To determine whether periods of disruption were associated with increased 'avoidable' hospital admissions and wider social inequalities in England.

DESIGN

Observational repeated cross-sectional study.

SETTING

England (January 2019 to March 2022).

PARTICIPANTS

With the approval of NHS England we used individual-level electronic health records from OpenSAFELY, which covered ~40% of general practices in England (mean monthly population size 23.5 million people).

PRIMARY AND SECONDARY OUTCOME MEASURES

We estimated crude and directly age-standardised rates for potentially preventable unplanned hospital admissions: ambulatory care sensitive conditions and urgent emergency sensitive conditions. We considered how trends in these outcomes varied by three measures of social and spatial inequality: neighbourhood socioeconomic deprivation, ethnicity and geographical region.

RESULTS

There were large declines in avoidable hospitalisations during the first national lockdown (March to May 2020). Trends increased post-lockdown but never reached 2019 levels. The exception to these trends was for vaccine-preventable ambulatory care sensitive admissions which remained low throughout 2020-2021. While trends were consistent by each measure of inequality, absolute levels of inequalities narrowed across levels of neighbourhood socioeconomic deprivation, Asian ethnicity (compared with white ethnicity) and geographical region (especially in northern regions).

CONCLUSIONS

We found no evidence that periods of healthcare disruption from the COVID-19 pandemic resulted in more avoidable hospitalisations. Falling avoidable hospital admissions has coincided with declining inequalities most strongly by level of deprivation, but also for Asian ethnic groups and northern regions of England.