CCU049: Healthcare utilisation in individuals with Long Covid

Project lead:
Amitava Banerjee, University College London

Most analysis on how people use healthcare services is a ‘rear-view mirror sport’, meaning that analysis is performed after the event. We aim to change it to more of a ‘through-the-windscreen sport’ to demonstrate healthcare utilisation and how we can better plan during pandemics. In this project, we seize the rare opportunity to look at healthcare utilisation of individuals with Long Covid, a new syndrome that originated from the COVID-19 pandemic.

This project addresses two challenges we face in Long Covid research:

  1. Identifying Long Covid patients using data from electronic health records (EHR) is difficult, as less than 2% of COVID-19 patients are recorded as having a ‘post-Covid condition’. The scale is likely higher, based on an Office for National Statistics (ONS) estimate that around 12% of COVID-19 patients developed Long Covid. Therefore, we need to find a better way of identifying patients with Long Covid.
  2. We know little about current healthcare utilisation in individuals with Long Covid, despite the number of COVID-19 patients estimated to have developed it, or the expected added pressure this might have on healthcare services over time.  More importantly, we are unaware whether the current practice for Long Covid is the best option. This information is crucial for funding allocations, public policies and healthcare practice.

To address these problems, we will first try to identify individuals with Long Covid and explore their use of healthcare, by linking and analysing a range of EHRs, to try to help the NHS or healthcare providers plan more efficiently. We will also study the impact of the vaccination programme on healthcare utilisation in individuals with Long Covid and how this changes over different waves of the COVID-19 pandemic.

Although this project will not only focus on cardiovascular disease, it is of interest as it can act as both a risk factor and outcome of Long Covid. We will compare how people with pre-existing cardiovascular disease and those who developed cardiovascular disease post-COVID use cardiovascular services. We will also compare the healthcare utilisation of individuals with and without cardiovascular disease.

This project will also evaluate the effectiveness and cost-effectiveness of current care for those with Long Covid, which will help to identify any inefficiency in Long Covid care, provide better support to patients, and inform policy and resource allocation.

Understanding current care for Long Covid will facilitate improvements in care and allow comparisons between different care pathways. Since the first wave of the pandemic, individuals with Long Covid have raised issues about being bounced around the system, for example, to have their breathlessness and brain fog checked. The idea of having an integrated care pathway (ICP) for Long Covid, the core of this project, originates from and is informed by patient experience.


Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control cohort analysis

  • Paper submitted to a journal (decision pending)
  • Preprint 19/10/23 can be viewed here
  • Code and phenotypes used to produce this paper are available in GitHub here