The Primary and Community Health Cohort is a sub-study of the the Sax Institute’s 45 and Up Study. It includes data on 31,000 Study participants living in Central and Eastern Sydney. This is linked to data from NSW admitted patient and emergency department systems, Medicare and the Pharmaceutical Benefits Scheme and the NSW register of deaths.
Chief Investigators & Other Investigators
A/Prof Margo Barr (Principal), A/Prof Elizabeth Comino, A/Prof Elizabeth Harris, Professor Mark Harris, Mr A.Y.M. Alamgir Kabir, Margaret Williamson, A/Prof Fiona Haigh (HERDU and CPHCE), A/Prof Ben Harris-Roxas, Dr Kylie Vuong (SPH), Ms Lou-Anne Blunden, Dr Ann-Marie Crozier, Ms Deb Donnelly (SLHD), Prof Fiona Blyth (USYD and SLHD), Mr Tony Jackson, Dr Sonia van Gessel, Ms Lisa Woodland, Dr Damian Conway (SESLHD), Dr Brendan Goodger (CESPHN)
Partnership Sponsors/Project Advisors
Dr Marianne Gale (SESLHD), Dr Teresa Anderson (SLHD), Dr Michael Moore (CESPHN), Prof Jean-Frederic Levesque (UNSW and ACI)
Dr Julie McDonald, Ms Jude Page, Ms Tish Bruce, Ms Natalie Hansen, Ms Rabia Khan, Mr Liam Shanahan, Ms Belinda Michie, Dr Shona Dutton, Ms Katherine Clinch, Ms Heidi Welberry, Prof John Hall, A/Prof Jane Lloyd
It is anticipated that by 2030 there will be a significant increase in the ageing of the population and people living with long term conditions (including cancer) in Central and Eastern Sydney (CES) area. At the same time, it is expected that there will be a shift to providing more health care in the community. In response to these challenges the Central and Eastern Sydney Primary and Community Health Research Consortium commenced in 2016 bringing together two LHDS (Sydney and South Eastern Sydney) and the co-terminous local PHN (Central and Eastern Sydney) in one partnership to establish the CES Primary and Community Health Cohort/Resource (CES-P&CH) to inform joined-up primary and community services planning, program development and evaluation.
- To continue and maintain a de-identified linked dataset - the CES-P&CH which will support health services research and evaluation allowing decision makers to better understand their community’s health care needs.
- To undertake research and evaluation of questions of particular interest to participating organisations in relation to access to primary and community health care and its impact on health service use.
- To investigate the relationship between health service use and personal characteristics, health outcomes, and to examine how these relationships vary according to a range of sociodemographic, lifestyle and health related characteristics over time
The CES-P&CH currently includes 10 datasets linked together by the Sax Institute and the Centre for Health Record Linkage (CHeReL) based on the 45 and Up Study cohort, including 30,645 participants resident in CES area (20,337 in SES and 10,308 in Sydney). The linked dataset is based on the 45 and Up Study—a cohort study with over quarter of a million NSW residents—of which 30,645 are resident in CES area (20,337 in SES and 10,308 in Sydney). The dataset was established in 2016 and was updated in 2018 and 2021. The dataset currently includes: 12 datasets and over 215 million records from 2006 onwards. The dataset is currently updated to Dec 2020.
This project has umbrella ethics approval until 2024 for mutually agreed health-service relevant research from the NSW Population & Health Services Research Ethics Committee.
All analysis is conducted within the secure environment of the Sax Institute’s SURE workspace.
The project management group oversees the project with representatives from all funding partners. All programs of work are agreed in advance by the management group and dependent on the specific research interests of the partners at a given time.
An analytical framework for analysing health service utilisation within CES-P&CH is shown in below. The risk and outcome variables include:
- Risk/Protective factors: Smoking, Physical activity, Fruit & Veg, Alcohol, Overweight/Obese, Treated for high BP, Treated for high cholesterol, Cared for/carer, Functional ability, Social capital, High Psychological Distress.
- Primary care: a. GP attendance, b. Continuity of primary care provider, c. Use of primary care and diagnostic services, and d. Medication use)
- Secondary care: a. First admission to hospital, b. Number of ED visits and hospital admissions, c. Total days in hospital, d. Cause-specific hospitalisation- including falls, stroke, heart failure, diabetes, e. Hospital readmission
- Interface/integration of care: a. Access to integrated care, b. Time to follow up by GP following discharge from hospital, c. Continuity and coordination of care.
Progress and capacity
To date nine research studies (seven major and two partner specific research studies) have been undertaken using the CES-P&CH: Impact of care plans on health outcomes; Impact of GP follow-up after hospitalisation on re-admissions; Association between social isolation and health service use; Predictors for high service use in older people; Health of Carers (SESLHD project); Defining a Mental Illness Cohort (SLHD project); Health of carers over time focusing on changing status; Weight/obesity and ageing focusing on the impact of GPs; Ways increased primary health care use could reduce potentially preventable hospitalisations and/or emergency department presentations (See reports, journal articles and conference presentations as listed below).
The CES-P&CH, is uniquely positioned to make a substantial contribution to improving primary health care in older people in Australia. The resource brings together primary health longitudinal data, service level data, cutting edge researchers, practitioners, service providers and data analysts to answer policy relevant research questions and to facilitate translation of research to policy and practice.
2021: Harris-Roxas B, Kabir A, Barr M. Understanding the caregiver role and challenges in Sydney, Australia: a population based linked cohort study of people aged 45 years and over. Poster at the Virtual NAPCRG Annual meeting. Nov 2021
2021: Buss VH, Varnfield M, Harris M, Barr M. Variation of lifestyle-based prognostic models for cardiovascular disease and diabetes. Australian Public Health Conference Sept 2021
2021: Barr M, Kabir A, Harris-Roxas B, Comino E, Jackson T, Crozier AM, Goodger B, Finch J, Harris M. All-cause mortality in Australia: impact of social isolation and living alone, Presented at the virtual World Congress of Epidemiology, Melbourne, Sept 2021. International Journal of Epidemiology, 50 (S1) https://doi.org/10.1093/ije/dyab168.060
2021: Harris-Roxas B, Kabir A, Kearns R, Webster G, Woodland L, Barr M (2021) Understanding the carer role and challenges in Central and Eastern Sydney in Australia: a population based linked cohort study of people aged 45 years and over. Presented at the Virtual International Conference on Integrated Care. May 2021.
- 2021: Harris-Roxas B, Kabir A, Kearns R, Webster G, Woodland L, Barr M. Understanding the carer role and challenges in Central and Eastern Sydney in Australia: a population based linked cohort study of people age 45 years and over. Presentation at the Virtual International Conference on Integrated Care, 1-3 Apr 2021.
2020: Barr M, Welberry H, Finch J, Blunden LA. Using multiple administrative health datasets to identify a mental illness cohort. Presented at the 2020 International Population Data Linkage Network Virtual Conference 1-13 Nov 2020.
2020: Barr M and Bleicher K. 45 and Up Study: Large Australian longitudinal linkage study of people age 45 years and over. Presented at the Society for Longitudinal and Lifecourse Studies Virtual Showcase. 9 Oct 2020.
2019: Jackson T, Barr M, Comino E, Welberry H, Kabir A, Harris-Roxas B, Lloyd J, Blunden L, Donnelly D, Goodger B, Harris M. Impact of social isolation and living alone on health service use, morbidity and mortality over time in Central and Eastern Sydney, Australia. Presented at the 2nd Asia Pacific Conference on Integrated Care, Melbourne, 11-13 Nov 2019.
- 2019: Barr M, Comino E, Welberry H, Kabir A, Harris-Roxas B, Lloyd J, Blunden LA, Jackson T, Donnelly D, Harris L, Harris M. Is living alone predictive or protective for social isolation among older people? Presentation at the Public Health Association, Australia Conference, Adelaide, 17-19 Sep 2019.
- 2019: Blunden LA, Lloyd J, Barr M, Welberry H, Comino E, Harris-Roxas B, Jackson T, Donnelly D, Harris L, Harris M. Understanding the medical determinants and health service needs of older people who experience loneliness in Sydney, Australia. Poster presentation at the International Conference on Integrated Care, San Sebastian, Spain.
- 2019: Stewart G, Tony Jackson T, Kathy Clinch K, Barr M, Blunden LA, Harris-Roxas B, Welberry H, Elizabeth Comino E, Lloyd J, Harris L, Harris M. Understanding the predictors of services use in older people to plan for and provide quality cost-effective care. Presentation at the International Conference on Integrated Care, San Sebastian, Spain.
- 2018: Harris M, Welberry H, Barr M, Hall J, Harris-Roxas B, Comino E. GP follow-up within 2 weeks of hospital discharge in a community dwelling population of residents in Central and Eastern Sydney, Australia; Presentation at the North American Primary Care Research Group (NAPCRG), Chicago USA.
- 2018: Barr M, Welberry H, Hall J, Comino E, Harris-Roxas B, Harris M. General Practitioner follow-up after hospitalisation: access and impact on health services. Poster presentation at the Primary Health Care Research and Information Service (PHCRIS) conference, Melbourne, VIC.
- 2017: McDonald J, Comino E, Harris E, Bruce T, Hansen N, Donnelly D, et al.. Integrated care for participants attending general practice: a record linkage study based on the 45 and Up population cohort study. International Journal of Integrated Care. 2017;17(3):A78. DOI: http://doi.org/10.5334/ijic.3190
- 2017: Welberry HJ; Comino E; Harris M, 2017, 'Exploring Access to Chronic Disease Management Services in Central and Eastern Sydney', in Exploring Access to Chronic Disease Management Services in Central and Eastern Sydney, 45 & Up Study Annual Forum, Sydney, presented at 45 & Up Study Annual Forum, Sydney, 24 - 24 October 2017
- 2017: Welberry HJ; Comino E; Harris MF, 2017, 'Chronic Disease Management in NSW: Examining patterns of MBS claims to inform care planning.', in Chronic Disease Management in NSW: Examining patterns of MBS claims to inform care planning., GP17 - The RACGP Conference for General Practice, Sydney, presented at GP17 - The RACGP Conference for General Practice, Sydney, 26 - 28 October 2017
- 2017: Welberry HJ; Comino E; Harris MF, 2017, 'Chronic Disease Management in NSW: Who receives a care plan through General Practice and does care planning reduce hospitalisation?', in 2017 Primary Health Care Research Conference: Handbook, 2017 Primary Health Care Research Conference, Brisbane, Australia, presented at 2017 Primary Health Care Research Conference, Brisbane, Australia, 07 - 09 August 2017, https://az659834.vo.msecnd.net/eventsairaueprod/production-phcris-public/2cc7093894634371b7693ebdc2c5c69d
- 2020: Barr M, Welberry H , Hall J, Comino E , Harris E , Harris-Roxas B , Jackson T , Donnelly D, Harris M. General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: access and impact on health services. Australian Health Review https://doi.org/10.1071/AH19285
- 2019: Welberry H, Barr ML, Comino EJ, Harris-Roxas BF, Harris E, Dutton S, Jackson T, Donnelly D, Harris MF. Do general practice management and/or team care arrangements reduce avoidable hospitalisations in Central and Eastern Sydney, Australia? BMC Health Services Research 2019; 19:811 https://doi.org/10.1186/s12913-019-4663-3
- 2019: Welberry H;Barr ML;Comino EJ;Harris-Roxas BF;Harris E;Harris MF, 2019, 'Increasing use of general practice management and team care arrangements over time in New South Wales, Australia', Australian Journal of Primary Health, http://dx.doi.org/10.1071/PY18113
- 2019: Barr ML, Welberry H, Comino EJ, Harris-Roxas BF, Harris E, Lloyd J, Whitney S, O’Connor C, Hall J, Harris MF. Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis. Primary Health Care Research & Development 2019; 20(e141): 1–9. doi: 10.1017/S146342361900077X.
A/Prof Margo Barr Phone: 02 9065 6041 Email: firstname.lastname@example.org
South Eastern Sydney Local Health District, Sydney Local Health District, Central and Eastern Sydney Primary Health Network
Sydney Local Health District, South Eastern Sydney Local Health District, Central and Eastern Sydney Primary Health Network