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Preventing Premature Mortality Audit July 2014

Preventing Premature Mortality Audit July 2014. Why?. To attempt to understand the characteristics of the premature deaths in Brighton and Hove from CVD, COPD and Diabetes in order to plan interventions to reduce the number of deaths

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Preventing Premature Mortality Audit July 2014

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  1. Preventing Premature Mortality Audit July 2014

  2. Why? • To attempt to understand the characteristics of the premature deaths in Brighton and Hove from CVD, COPD and Diabetes in order to plan interventions to reduce the number of deaths • To test the hypothesis that the ‘hard to reach’ are not getting optimal care • Adults aged 18-74

  3. Deaths included in Brighton & Hove PPMA – identified from ONS Primary Care Mortality Database

  4. Directly age standardised mortality rates, per 10,000 patients, by locality

  5. Directly age standardised mortality rates, per 10,000 patients, by practice

  6. Directly age standardised mortality rates (per 10,000 patients) against practice IMD

  7. Characteristics of Premature Deaths- CVD • 339 CVD deaths • 240 on related register (71%) • 62 on depression register (26% vs 6% B&H overall) • 38 excepted from a related register (16% vs 7% B&H overall) • 38 on non related register (11%) • 61 on no register (18%)

  8. Characteristics of Premature Deaths- Stroke • 62 stroke deaths • 41 on related register (66%) • 8 on depression register (20% vs 6% B&H overall) • 11 excepted from a related register (27% vs 7% B&H overall) • 6 on non related register (10%) • 15 on no register (24%)

  9. Characteristics of Premature Deaths- COPD • 167 COPD deaths • 138 on related register (83%) • 44 on depression register (32% vs 6% B&H overall) • 56 excepted from a related register (41% vs 7% B&H overall) • 24 on non related register (14%) • 5 on no register (3%)

  10. Characteristics of Premature Deaths- Diabetes • 155 diabetes deaths • 150 on related register (97%) • 51 on depression register (34% vs 6% B&H overall) • 42 excepted from a related register (28% vs 7% B&H overall) • 2 on non related register (1%) • 3 on no register (2%)

  11. Attrition triangle examples 1

  12. Attrition triangle example 2

  13. Recording of smoking, BMI and alcohol consumption

  14. Smoking, overweight/obese and increasing/high risk alcohol consumption (record 2 years prior to death)

  15. High BP (recorded in 2 years prior to death)

  16. Other factors • No record of health checks for any patients • Fewer than five patients with record of drugs misuse

  17. Data quality issues • 82 ONS death records with no corresponding GP death record • 72 deaths registered at more than one GP practice • 335 deaths with different date of death recorded in ONS and GP systems

  18. What next? • Many areas need further investigation • Practices will be given own patient list • In-practice audit to enhance our understanding of patient, practice and secondary care factors - conducted by practice OR by a team from CCG/PH • New clinical facilitator post

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