Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

  1. Claire X. Zhang
  2. Yamina Boukari
  3. Neha Pathak
  4. Rohini Mathur
  5. Srinivasa Vittal Katikireddi
  6. Parth Patel
  7. Ines Campos-Matos
  8. Dan Lewer
  9. Vincent Nguyen
  10. Greg C.G. Hugenholtz
  11. Rachel Burns
  12. Amy Mulick
  13. Alasdair Henderson
  14. Robert W. Aldridge

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Abstract

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  1. Version published to 10.1016/j.lanepe.2022.100455
  2. ScreenIT

    SciScore for 10.1101/2022.03.14.22272283: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    RandomizationTo comply with CPRD’s data minimisation policy, we randomly sampled non-migrants from the reduced initial cohort at a ratio of 1:4 migrants to non-migrants and then linked this cohort to IMD data.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    To account for migrants’ younger age at cohort entry, later cohort entry, shorter time between entering the CPRD GOLD database and entering the cohort, and shorter follow-up time, we conducted two pre-pandemic and one ITS sensitivity analyses.
    GOLD
    suggested: (GOLD, RRID:SCR_000188)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of our study include the under-recording of migration-related indicators in EHRs, which could result in migrants being misclassified as non-migrants (20) and a selection bias towards migrants who are more engaged with primary care. These biases would likely result in an underestimation of differences between groups. As we reported previously, the migration code list used in this study is less representative of migrants aged over 50 (20). As a result, findings concerning older migrants should be interpreted with caution. Another limitation is the lack of power in the 18-category ethnicity ITS analysis; these findings should also be interpreted with caution. Our study could also have been affected by changes in size and composition of the migrant population during the study period due to the pandemic itself and/or other factors e.g. the UK’s exit from the EU. We found pronounced widening of differences between migrants’ and non-migrants’ consultation rates in both White British and White non-British groups, who may represent EU migrants. The lack of timely de-registration of migrants who leave GP practices and/or emigrate from the UK could contribute to a greater amount of false follow-up time (i.e. a numerator-denominator bias) and, thus, an underestimation of consultation rates. Finally, we provide quantitative evidence on migrants’ primary care utilisation, which is useful for service planning; however, we did not assess clinical need and, therefore, cannot make ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.03.14.22272283v1 on medRxiv