Social exclusion, such as that experienced by people with substance use disorders, homeless people, people with severe and enduring mental illness, prisoners and certain minorities (Travellers, aboriginal people) causes severe socio-economic stress and health inequity with dramatic increased risk of chronic disease and reductions in life-expectancy. Social exclusion is often experienced in an intersectional way, with any individual belonging to more than one of the groups above. Health services are not designed to meet the complex needs of socially excluded people and this results in increased usage of unscheduled health care (ED visits and unscheduled inpatient admissions) and associated costs and grossly inequitable outcomes. In Ireland, there is a lack of an integrated data set which can be used to identify people who are socially excluded and to examine the patterns of ill health and healthcare utilization to inform interventions to improve health equity.
We propose to develop and validate an accessible integrated longitudinal national-level database of health and social care utilisation with a derived variable to identify those who are socially excluded. This information will be used by the lead knowledge users, PIs and collaborators to design national pathways and plan services to reduce health inequality.
