A National Health Service in 'Serious Trouble': What do multiple long-term conditions tell us about deterioration in health among people accessing hospital care in the North East of England? - An analysis of electronic health records.

OBJECTIVES: To estimate the prevalence of multiple long-term conditions (MLTC) among people accessing hospital care in North East England, and to assess associations with age, sex, ethnicity and neighbourhood deprivation. DESIGN: Analysis of electronic health records. SETTING: Secondary care. PARTICIPANTS: All adults, 18 years and above, with  ≥ 1 admission to Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH) between July 2018 and June 2019 (N = 88,117, 51% women) or between July 2021 and June 2022 (N = 83,036, 51% women). MAIN OUTCOME MEASURES: MLTC; ≥2 long-term conditions. RESULTS: Between July 2018 and June 2019, overall prevalence of MLTC was 49.6%, and between July 2021 and June 2022 it was 61.0%. Older age and living in a more deprived neighbourhood were consistently associated with increased risk of MLTC, whereby people living in the most deprived neighbourhoods had a prevalence of MLTC equivalent to people from the least deprived neighbourhoods a decade older. Associations between neighbourhood deprivation and increased MLTC risk were stronger in younger adults; relative risk of MLTC was 1.74 (95% confidence interval: 1.49-2.02) when comparing people aged 30-39 living in the most and least deprived neighbourhoods. CONCLUSIONS: Among adults accessing inpatient hospital care in North East England, the prevalence of MLTC is high in all age groups, has increased since the COVID-19 pandemic and has a greater impact on younger adults from more deprived neighbourhoods. This highlights the sheer scale of the challenge that MLTC present in hospitals and the value of harnessing information at a local level as we look to redesign hospital care fit for the future.