%0 Journal Article
%T The digital divide between primary and secondary care: An analysis using SARS-CoV-2 hospital admissions.
%A Sagi A
%A Asopa V
%A Mitchell B
%A Shiyamasundaran M
%A Koch C
%A Getachew F
%A Afzal I
%A Sochart D
%A Field R
%J Health Informatics J
%V 30
%N 3
%D 2024 Jul-Sep
%M 39048524
%F 2.934
%R 10.1177/14604582241249929
%X Using data from two ED. departments of 773 patients admitted with SARS-CoV-2, ICD-10 codes derived from the General Practitioner - Summary Care Record (GP-SCR) and Emergency Department (ED.) records were analysed for code discrepancies and whether this related to increased mortality. The average number of ICD-10 codes in both GP-SCR and ED. records was higher for patients who died than patients who survived (all p < .0001). Pre-existing GP digital data provides a better prediction of mortality than data collected manually during admission clerking in the ED. Up to 78.47% of GP-SCR codes were missed in the ED. records and up to 45.49% of the ED. record codes were not in the GP-SCR. A subset of missed ICD-10 codes were identified as being able to predict outcome; a trend towards increasing death rate as the proportion of missed codes increases. Initiatives to make the GP-SCR available to the wider healthcare community should improve patient care and reduce bias during development of machine learning based algorithms.