Project #182:
Incidence of long-term conditions in England before and after the onset of the COVID-19 pandemic

Rationale: During the COVID-19 pandemic, clinical pressures and stay-at-home guidance meant that fewer patients attended their GP or hospital for non-COVID-19-related conditions. This is likely to have resulted in a fall in the number of people newly diagnosed with long-term health conditions, such as kidney disease, heart conditions and mental health conditions. Studies from other nations have shown that the pandemic affected the number of people newly diagnosed with some diseases more than others; however, the impact of the pandemic on diagnosis rates for long-term health conditions in England is poorly understood. Additionally, it is not clear whether some groups of patients were affected more than others - for example, older adults or those from socioeconomically disadvantaged backgrounds. We will address this important knowledge gap in our study.

Aim and methods: Our goal is to use routinely collected health data through OpenSAFELY to describe the impact of the COVID-19 pandemic on the number of people with new diagnoses of selected long-term health conditions in England and Wales. We will estimate how many people were newly diagnosed with long-term health conditions chosen from different disease areas, and describe how diagnosis rates changed in the pre-pandemic (March 2015 to February 2020), early pandemic (March 2020 to Feb 2021), and later/post-pandemic recovery periods (March 2021 to December 2024).

By including a range of diseases and patient populations over this time period, it will help us to better understand the relative impact of the pandemic across different health conditions and patient groups. We will use statistical models to compare the number of people who had new diagnoses of these long-term conditions, and describe how this changed as a consequence of the pandemic. We will describe the relative impact of the pandemic on diagnosis rates by age group, sex, ethnicity and socioeconomic status.

Expected output of project: This project will provide important information on the number of people who had delays in diagnosis as a consequence of the pandemic. By describing the impact of the pandemic across different diseases and patient groups, it will help in the development of quality improvement strategies aimed at reducing diagnostic delays and improving patient outcomes, which will be applicable across multiple diseases.