Level In England Research Articles

Exploring decision-making practices during coaching sessions in grassroots youth soccer: a mixed-methods study.

Decision-making ability in players during match-play is mostly acquired through practice activities with the same underlying structure as competition. However, researchers have not fully investigated how coaches design practice sessions at the participation level of the sport (i.e. 'grassroots'), or why they use a particular activity at a specific time point. This study explores the practice activities employed by youth soccer coaches at the participation level in England and aims to understand their underlying intentions. Twelve male coaches working with players aged 9-11 years across ten clubs in the London region participated. Thirty-five practice sessions were filmed and analysed to assess the proportion of time spent in activities involving 'non-active decision-making' (e.g., technical practices, fitness training) versus 'active decision-making' (e.g., small-sided and conditioned games, skills practice with realistic opposition). A brief on-field interview with the coaches about the session purpose took place immediately after each systematic observation. Coaches allocated similar amounts of time to activities with active (M = 41%) and non-active (M = 42%) decision making, with the remaining 17% being transitions. There was a common progression from non-active decision-making activities early in the session towards increased active decision-making later in the session. Interviews with coaches revealed a belief in the necessity of frequent non-active decision-making practices for technique development, despite potential disparities with improving match performance. Findings highlight a potential gap between scientific understanding and coaching practices for young soccer players at the participation level, suggesting implications for coach education programmes and the optimisation of player development strategies.

Comparing Health and safety sentencing in NZ and abroad

A review of aspects of the sentencing regime in New Zealand with a focu on financial capacity and alternative orders. It highlights the different maximum penalty and approach to settng fine levels in England & Wales as well as literature from Australia regarding the need for regulators and courts to engage with alternative orders.

The effect of public tolerance towards corruptive behaviour on healthcare efficiency and equity – The case of the UK's COVID-19 vaccination programme

Over the past four years, the COVID-19 pandemic has caused significant uncertainty, suffering, and economic disruption on a global scale. In response, governments have been under pressure to ensure equitable vaccine access while meeting vaccination targets quickly. These challenging circumstances created opportunities for nepotism and bribery, increasing attention to corruption risks associated with the pandemic response. This study investigates the relationship between public attitudes towards corruptive behaviour and the efficiency and equity of the UK's COVID-19 vaccination programme. It integrates primary data on public tolerance towards corruptive behaviour with secondary data on the efficiency of the vaccination program at the local authority level in England and Scotland. Employing a survival analysis approach, we estimate Cox Proportional Hazards Models to examine the time required to reach vaccination targets. Our findings suggest moderate tolerance towards corruptive behaviour among the British public, with 28% of survey participants considering monetary bribery and 34% considering nepotism/favouritism as acceptable means to secure early vaccination access. Notably, while public tolerance towards corruptive behaviour generally had a negative impact on the efficiency of the local rollout of the vaccination programme, it appeared to have accelerated its rollout in politically aligned local authorities governed by the Conservative and Unionist Party. However, this increase in efficiency seems to have come at the cost of reduced equity in vaccine distribution. These findings suggest a trade-off between efficiency and equity in vaccine distribution during public health crises, emphasising the need for balanced health policies that ensure fair and effective distribution of vaccines in the future.

Support for banning sale of smoked tobacco products among adults who smoke: findings from the International Tobacco Control Four Country Smoking and Vaping Surveys (2018–2022)

BackgroundMany people continue to smoke despite strong policies to deter use, thus stronger regulatory measures may be required. In four high-income countries, we examined whether people who smoke would support...

#1402 CCG-level coding for chronic kidney disease and regional kidney replacement therapy incidence: an ecological study in England

Abstract Background and Aims With ageing of the population both prevalence of chronic kidney disease (CKD) and incidence of kidney replacement therapy (KRT) are rising. Existing research suggests that adding a formal diagnosis-code for CKD to the health record in those affected is associated with better implementation of recommended care and fewer hospitalisations for cardiovascular diseases. Furthermore, reliable estimates of the future need of KRT cannot be extrapolated from previous years after the COVID-19 pandemic. This ecological study investigates whether coding for CKD is associated with KRT incidence at clinical commissioning group (CCG) level in England. Method KRT incidence rates for CCGs in England were calculated using UK Renal Registry (UKRR) data from 01/2019 to 12/2021. Data on the percentage of uncoded CKD patients (PUCP) who had laboratory evidence of CKD but lacked a diagnostic code were obtained from the Cardiovascular Disease Prevention Audit (CVDPREVENT), a national primary care audit that extracts routinely held general practitioner (GP) data. The PUCP was modelled both as a continuous and a categorical variable using quintiles with an equally large population in each quintile to investigate potential non-linear associations. Data on potential confounders and acute kidney injury (AKI) mortality as a marker for underlying population frailty were obtained from CVDPREVENT and the UKRR, respectively. A hierarchical conceptual framework was used to assess the association between the PUCP and KRT incidence, in which covariates were grouped into sociodemographic, healthcare quality and health status covariates. Poisson models assessed the association between PUCP and KRT incidence and effect modification by AKI mortality was investigated using a simplified model for which AKI mortality was recoded to a binary variable. Results The crude overall KRT incidence rate was 141.30/1 000 000, ranging from 84.54 to 204.05/1 000 000 in the different CCGs (Fig. 1A). The mean PUCP was 15.47% (SD 5.55), ranging from 3.68% to 30.28%, with no immediately identifiable association with KRT incidence (Fig. 1B). Univariable Poisson regression showed no evidence of an association between the crude PUCP as a continuous measure and KRT incidence (p = 0.886). However, when included as a categorical variable, there was strong evidence (p < 0.001) for a difference in the crude KRT incidence rates, indicating a non-linear association. After adjusting for all covariates, there was evidence for an association between the PUCP as a continuous measure and KRT incidence (RR 1.004, 95% CI 1.000-1.008, p = 0.029). However, the PUCP was also considered as a categorical variable and there was still evidence of a difference in rates (p = 0.030) with the CCGs in the lowest PUCP quintile having a lower KRT incidence than the others. Considering the PUCP as a continuous variable, there was some evidence (p = 0.033) for effect modification: in CCGs with low AKI mortality, there was no evidence of an association between the PUCP and KRT incidence (RR 1.001, 95% CI 0.996-1.005, p = 0.823), whereas a 7% increase in KRT incidence for every 10% increase in uncoded CKD patients was found in CCGs with high AKI mortality (RR 1.007, 95% CI 1.003-1.012, p = 0.024) (Fig. 2A). Considering the PUCP as a categorical variable, there was very strong evidence (p < 0.001) for effect modification by AKI mortality: In CCGs with low AKI mortality, there was no evidence that rates were different in higher quintiles of the PUCP compared to the lowest. However, in CCGs with high AKI mortality, KRT incidence rates from the second up to the fifth quintile of the PUCP were between 10.3% and 18.5% higher than in the first quintile (Fig. 2B). Conclusion At a geographical level in England, the data suggest that the prevalence of not having formally diagnosed CKD is non-linearly associated with a higher KRT incidence rate, especially in areas with a high AKI mortality. The PUCP can be seen as a proxy for care quality. Therefore, improved care quality might be associated with lower KRT incidence rates. After the COVID-19 pandemic, PUCP follow-up data may be the first way to estimate future KRT needs and support the planning process.

Exploring the Multidimensional Characteristics of Selected and Non-Selected White British and British South Asian Youth Cricketers: An Exploratory Machine Learning Approach

Selection into a County Age Group (CAG; under 10–18) programme is the first step for young aspiring cricketers on their journey to achieving professional status. Recognising that the British South Asian (BSA) community represents 30% of those who play recreational cricket compared to less than 5% of those who are selected to play at the professional level in England and Wales, it is important to better understand the characteristics of selected and non-selected players based on ethnicity to identify potential sociocultural differences during selection. Thus, the purpose of this study was to investigate the multidimensional factors that differentiated between selected and non-selected adolescent male cricketers as well as between White British (WB) and BSA selected players into a CAG programme. A total of 82 male participants aged between 14 and 17 years were included (mean = 15.3 ± 1.1 years: selected n = 33 and non-selected n = 49: WB n = 34, BSA n = 44, Other n = 4). In total, 104 characteristics were measured over nine tests, which were subsequently placed into five overarching factors: (a) physiological and anthropometrical, (b) perceptual–cognitive expertise, (c) psychological, (d) participation history, and (e) socio-cultural influences. A Bayesian binomial regression was performed in rSTAN using a weak normal prior to highlight differentiators in selection as well as differences between WB and BSA selected players. The results highlighted that athleticism, wellbeing and cohesion, the number of older brothers, and being born in birth quarters two and three were positively correlated with player selection into a CAG. Conversely, increases in psychological scores, a greater number of younger brothers and older sisters, as well as antisocial behaviour resulted in a reduced chance of player selection. Finally, several developmental factors (i.e., athleticism, wellbeing and cohesion, psychological distress, and levels of anti-social behaviour) differed based on ethnicity. These exploratory findings serve as a useful opening to highlight there are important differences to consider based on selection and ethnicity in CAG cricket.

Chronic back pain prevalence at small area level in England - the design and validation of a 2-stage static spatial microsimulation model

Spatially disaggregated estimates provide valuable insights into the nature of a disease. They highlight inequalities, aid public health planning and identify avenues for further research. Spatial microsimulation is advantageous in that it can be used to create large microdata sets with intact microlevel relationships between variables, which allows analysis of relationships between variables locally. This methodological paper outlines the design and validation of a 2-stage static spatial microsimulation model for chronic back pain prevalence across England, suitable for policy modelling. Data used was obtained from the Health Survey for England and the 2011 Census. Microsimulation was performed using SimObesity, a previously validated static deterministic program, and the synthetic chronic back pain microdataset was internally validated. The paper also highlights modelling considerations for researchers embarking on similar work, as well as future directions for research in this area of microsimulation.

Role of car segment and fuel type in the choice of alternative fuel vehicles: A cross-nested logit model for the English market

In this article, we study the role of car segment and fuel type in the choice of alternative fuel vehicles and in the prediction of its market. For this purpose, we propose a joint choice cross-nested logit model to understand the demand for alternative fuel vehicles (AFV) and to study substitutional patterns between fuel types and vehicle segments with a full revealed preference approach, using only publicly available real data at disaggregate (household) level in England. Our results show that, as hypothesised, fuel type choice is not independent from car segment choice. The correlation patterns in the chosen specification reveal that individual car alternatives belonging to the same car segment are strongly correlated, while a weaker correlation exists between alternatives from different segments which share the same fuel type. The results suggest that creating awareness for cleaner fuel alternatives might be more effective if a targeted approach that considers these substitutional patterns is used. From a policy standpoint, while purchase prices play an important role and government policies have been concentrated in reducing the gap between ICE vehicles and AFVs in this dimension, our models stress the relevance of the operating cost variable, suggesting that its effect might also be crucial in the purchase decision.

Enacting national school exclusion policy at the local level in England: is it black and white?

ABSTRACT This paper explores education professionals’ interpretations of national school exclusion policy in England and the different ways in which schools use and do school exclusion. Drawing on semi-structured interview data collected as part of my DPhil research into the enactment of school exclusion policy in one local authority in England, I investigate the extent to which national policy is understood as a clear set of imperatives or open to interpretation, and the perceived need for consistency versus flexibility in its application. I also explore how accountability frameworks and other national and local policies, including behaviour, safeguarding, and special educational needs and disability policies, are seen to interact with and influence how decisions around school exclusion are made – specifically what and when mitigating factors are considered – and highlight other contextual dimensions (situated, professional, material and external), which are seen to weave together and influence a school’s position towards school exclusion and their sense- and decision-making. In so doing, I reveal how national school exclusion policy becomes variously recontextualised and translated into practice at the local level.

Bayesian spatial modelling of localised SARS-CoV-2 transmission through mobility networks across England.

In the early phases of growth, resurgent epidemic waves of SARS-CoV-2 incidence have been characterised by localised outbreaks. Therefore, understanding the geographic dispersion of emerging variants at the start of an outbreak is key for situational public health awareness. Using telecoms data, we derived mobility networks describing the movement patterns between local authorities in England, which we have used to inform the spatial structure of a Bayesian BYM2 model. Surge testing interventions can result in spatio-temporal sampling bias, and we account for this by extending the BYM2 model to include a random effect for each timepoint in a given area. Simulated-scenario modelling and real-world analyses of each variant that became dominant in England were conducted using our BYM2 model at local authority level in England. Simulated datasets were created using a stochastic metapopulation model, with the transmission rates between different areas parameterised using telecoms mobility data. Different scenarios were constructed to reproduce real-world spatial dispersion patterns that could prove challenging to inference, and we used these scenarios to understand the performance characteristics of the BYM2 model. The model performed better than unadjusted test positivity in all the simulation-scenarios, and in particular when sample sizes were small, or data was missing for geographical areas. Through the analyses of emerging variant transmission across England, we found a reduction in the early growth phase geographic clustering of later dominant variants as England became more interconnected from early 2022 and public health interventions were reduced. We have also shown the recent increased geographic spread and dominance of variants with similar mutations in the receptor binding domain, which may be indicative of convergent evolution of SARS-CoV-2 variants.

Social Statistics Transformation: Understanding the population through the production of income by ethnicity statistics from administrative data

ObjectivesThe lack of an income question on the Census has meant the production of multivariate income by ethnicity statistics has not been possible in census outputs to date. Our ambition is to provide individual-level records for every member of the usually resident population of England and Wales using admin data.
 MethodExciting progress has been made in the development of admin-based characteristics measures, including the ongoing feasibility research to produce admin-based datasets on ethnic group and income. Demonstrated improved results include the coverage of the population steadily increasing and methods to create these datasets gradually improving.
 Access to these record-level administrative datasets has allowed us to combine admin-based income and ethnicity measures developed in previous research, linking individuals between the two. We review the coverage of the combined dataset and the feasibility of producing multivariate statistics at subnational levels in England and Wales for the first time.
 ResultsThis presentation will showcase our innovative progress so far. By combining admin-based income and admin-based ethnicity datasets, we established an income and a stated ethnicity for 77.1% of people in England and 82.1% of people in Wales aged 16 years and over in the admin-based Statistical Population Dataset (our population base).
 For the first time, we have produced income percentiles for ethnic groups at different levels of geography in England and Wales including national figures, regional figures and figures for local authorities and lower layer super output areas; although statistical disclosure control means that some of the figures have been suppressed.
 We will highlight some of the challenges in using administrative data sources to produce these statistics and in assessing their statistical quality.
 ConclusionOur research developing these statistics is truly novel and shows much promise. Future work will include research to improve the univariate admin-based measures that are used, to continue to explore the limitations of the combined dataset, to explore the data by occupied address, and explore methods to adjust for missingness.

Latin and Greek in English Primary Schools – seedlings of a classical education

AbstractThis article describes some of the main features of classical languages and history learning at the primary school level in England at the current time. It briefly examines the context and education policy background and government and teachers' beliefs in the value and status of classical subjects, especially the Latin language as an aid to learning other languages and as a support for developing and improving students' English literacy. There is some overlap with the literature review co-authored by Holmes-Henderson and Kelly for the British government (Holmes-Henderson and Kelly, 2022) and a recent piece by myself about provision of teaching and resources in the Bulletin of the Council of University Classics Departments (Hunt, 2022a). I hope to develop further some of these ideas and draw out some discussions about resources, pedagogy and learning aims for possible future directions of classical languages learning at the primary level.

Uptake and adoption of the NHS App in England: an observational study.

Technological advances have led to the use of patient portals that give people digital access to their personal health information. The NHS App was launched in January 2019 as a 'front door' to digitally enabled health services. To evaluate patterns of uptake of the NHS App, subgroup differences in registration, and the impact of COVID-19. An observational study using monthly NHS App user data at general-practice level in England was conducted. Descriptive statistics and time-series analysis explored monthly NHS App use from January 2019-May 2021. Interrupted time-series models were used to identify changes in the level and trend of use of different functionalities, before and after the first COVID-19 lockdown. Negative binomial regression assessed differences in app registration by markers of general-practice level sociodemographic variables. Between January 2019 and May 2021, there were 8 524 882 NHS App downloads and 4 449 869 registrations, with a 4-fold increase in App downloads when the COVID Pass feature was introduced. Analyses by sociodemographic data found 25% lower registrations in the most deprived practices (P<0.001), and 44% more registrations in the largest sized practices (P<0.001). Registration rates were 36% higher in practices with the highest proportion of registered White patients (P<0.001), 23% higher in practices with the largest proportion of 15-34-year-olds (P<0.001) and 2% lower in practices with highest proportion of people with long-term care needs (P<0.001). The uptake of the NHS App substantially increased post-lockdown, most significantly after the NHS COVID Pass feature was introduced. An unequal pattern of app registration was identified, and the use of different functions varied. Further research is needed to understand these patterns of inequalities and their impact on patient experience.

Community factors and excess mortality in the COVID-19 pandemic in England, Italy and Sweden.

Analyses of coronavirus disease 19 suggest specific risk factors make communities more or less vulnerable to pandemic-related deaths within countries. What is unclear is whether the characteristics affecting vulnerability of small communities within countries produce similar patterns of excess mortality across countries with different demographics and public health responses to the pandemic. Our aim is to quantify community-level variations in excess mortality within England, Italy and Sweden and identify how such spatial variability was driven by community-level characteristics. We applied a two-stage Bayesian model to quantify inequalities in excess mortality in people aged 40 years and older at the community level in England, Italy and Sweden during the first year of the pandemic (March 2020-February 2021). We used community characteristics measuring deprivation, air pollution, living conditions, population density and movement of people as covariates to quantify their associations with excess mortality. We found just under half of communities in England (48.1%) and Italy (45.8%) had an excess mortality of over 300 per 100 000 males over the age of 40, while for Sweden that covered 23.1% of communities. We showed that deprivation is a strong predictor of excess mortality across the three countries, and communities with high levels of overcrowding were associated with higher excess mortality in England and Sweden. These results highlight some international similarities in factors affecting mortality that will help policy makers target public health measures to increase resilience to the mortality impacts of this and future pandemics.

Levelling up or widening the gap? An analysis of community renewal fund allocation in English regions using an economic resilience index

ABSTRACT This paper assesses the relationship between economic resilience in English regions and the allocation of the UK government’s Community Renewal Fund (CRF). The CRF is part of the government’s ‘Levelling Up’ agenda to address place-based inequalities. Economic resilience is measured using a composite index comprising productivity, skills, unemployment, population density and household income. Data were obtained for the five indicators at local authority (LA) level in England. Regional resilience scores were produced by calculating the weighted mean score of the constituent LAs. Regional resilience values were used to generate an ‘expected share’ funding allocation, which was compared with the actual allocation using differences and correlation. Regional resilience scores ranged from 28.5 (North East) to 66.6 (London). A total of £125.56 million was allocated in the first round of the CRF. All regions in the North received less than their expected share allocation of the CRF, with the least resilient region in England (North East) receiving £13.4 million less. The South West received £9.9 million more than their expected share. All regions in the North of England received less than their expected share allocation of the CRF. There was no significant correlation between resilience values and CRF allocations (r = −0.16, p = 0.68). The current method for CRF allocation may therefore widen existing inequalities rather than ‘level up’.

The association between the proportion of Brexiters and COVID-19 death rates in England

RationaleA cultural divide may exist between a set of people who accept and a set of people who reject the advice of experts. This cultural divide may have important consequences and policy implications, especially in times of severe crisis. ObjectiveEcological study of whether there exists a significant conditional correlation between two variables that appear unrelated except for attitude towards experts: (1) Proportion of people voting in favour of remaining in the European Union in 2016 and (2) COVID-19 outcomes measured by death rates and vaccination rates. A significant conditional correlation would indicate that polarized beliefs have important consequences across a broad spectrum of societal challenges. MethodsThis study uses simple descriptive statistics and multiple linear regression, considering confounders suggested in the related literature, with data at the District level in England. ResultsDistricts where people voted most heavily in favour of remaining in the EU (top quintile) had nearly half the death rate of districts in the bottom quintile. This relationship was stronger after the first wave, which was a time when protective measures were communicated to the public by experts. A similar relationship was observed with the decision to get vaccinated, and results were strongest for the booster dose, which was the dose that was not mandatory, but highly advised by experts. The Brexit vote is the variable most correlated with COVID-19 outcomes among many variables including common proxies for trust and civic capital or differences in industry composition across Districts. ConclusionsOur results suggest a need for designing incentive schemes that take into consideration different belief systems. Scientific prowess – such as finding effective vaccines – may not be sufficient to solve crises.

Analysing the role of police officer strength in the crime drop in England

Abstract According to evidence from the Crime Survey for England and Wales (CSEW), there have been significant falls in crime levels in England and Wales since the 1990s. Many hypotheses have been proposed to explain these falls. However, there is scarce research on the role of the number of police officers in bringing about the crime drop in the UK. We fitted multilevel models to analyse the role of the number of police officers in the crime drop in England between 1991 and 2001 using a variety of data sources, including police recorded crime data, UK Census data, and police workforce data. We found that the role of police officer strength in the crime drop in England was limited to vehicle thefts, thefts from vehicle, and thefts from person. Given the relatively mixed picture, we recommend that police forces should focus on what newly recruited police officers do and where they are deployed, as opposed to becoming too focussed on the number of officers. More implications of the findings in relation to the recent Police Uplift Programme are discussed.

Ethnic inequalities in patient satisfaction with primary health care in England: Evidence from recent General Practitioner Patient Surveys (GPPS).

This paper aims to improve understanding of factors that contribute to persistent ethnic disparities in patient satisfaction in England. The specific objectives are to (i) examine ethnic differences in patient satisfaction with their primary care in England; and (ii) establish factors that contribute to ethnic differences in patient satisfaction. The study is based on secondary analysis of recent General Practitioner Patient Survey (GPPS) datasets of 2019, 2020 and 2021. Descriptive bivariate analysis was used to examine ethnic differences in patient satisfaction across the three years. This was followed with multilevel linear regression, with General Practice (GP) at level-1 and Clinical Commissioning Group (CCG) at level-2 to identify factors contributing to ethnic differences in patient satisfaction. The findings show consistent negative correlations between the proportion of patients reporting good (very or fairly good) overall experience and each of the ethnic minority groups. Further examination of the distribution of patient satisfaction by ethnicity, based on combined ethnic minority groups, depicted a clear negative association between ethnic minority group and patient satisfaction at both GP and CCG levels. Multilevel regression analysis identified several service-related factors (especially ease of using GP website and being treated with care and concern) that largely explained the ethnic differences in patient satisfaction. Of all factors relating to patient characteristics considered in the analysis, none was significant after controlling for GP service-related factors. Ethnic minority patients in England continue to consistently report lower satisfaction with their primary health care in recent years. This is largely attributable to supply (service related) rather than demand (patient characteristics) factors. These findings have important implications for health care system policy and practice at both GP and CCG levels in England.

Community-level characteristics of COVID-19 vaccine hesitancy in England: A nationwide cross-sectional study

One year after the start of the COVID-19 vaccination programme in England, more than 43 million people older than 12 years old had received at least a first dose. Nevertheless, geographical differences persist, and vaccine hesitancy is still a major public health concern; understanding its determinants is crucial to managing the COVID-19 pandemic and preparing for future ones. In this cross-sectional population-based study we used cumulative data on the first dose of vaccine received by 01-01-2022 at Middle Super Output Area level in England. We used Bayesian hierarchical spatial models and investigated if the geographical differences in vaccination uptake can be explained by a range of community-level characteristics covering socio-demographics, political view, COVID-19 health risk awareness and targeting of high risk groups and accessibility. Deprivation is the covariate most strongly associated with vaccine uptake (Odds Ratio 0.55, 95%CI 0.54-0.57; most versus least deprived areas). The most ethnically diverse areas have a 38% (95%CI 36-40%) lower odds of vaccine uptake compared with those least diverse. Areas with the highest proportion of population between 12 and 24 years old had lower odds of vaccination (0.87, 95%CI 0.85-0.89). Finally increase in vaccine accessibility is associated with COVID-19 vaccine coverage (OR 1.07, 95%CI 1.03-1.12). Our results suggest that one year after the start of the vaccination programme, there is still evidence of inequalities in uptake, affecting particularly minorities and marginalised groups. Strategies including prioritising active outreach across communities and removing practical barriers and factors that make vaccines less accessible are needed to level up the differences.

Drugs utilization profile in England and Wales in the past 15 years: a secular trend analysis

BackgroundMedication use assessment has a critical role in promoting the effective and rational use of pharmaceutical medications. There are no studies that have explored the utilization of all medications in England and Wales in the past 15 years without restrictions in the age group being studied or class of medications.AimTo explore the medication utilization pattern of dispensed medications in England and Wales in the past 15 years.MethodA secular trend analysis study using publically available dispensing data on the population level in England and Wales for the duration between 2004 and 2019. Medication dispensing data was extracted from the Prescription Cost Analysis database.ResultsMedication prescriptions rate increased by 42.6% [from 1,345,095.75 (95% CI 1,345,004.25 – 1,345,187.26) in 2004 to 1,918,138.48 (95% CI 1,918,038.38 – 1,918,238.57) in 2019 per 100,000 persons, trend test, p < 0.001]. During the study period, the most common medication prescriptions were for the cardiovascular system, central nervous system, and endocrine system, which accounted for 30.2%, 18.8%, and 9.4%, respectively. The rate of medication prescriptions for skin, immunological products and vaccines, infections, and musculoskeletal and joint diseases decreased by 18.4%, 15.8%, 9.8%, and 5.7%, respectively.ConclusionThe last two decades have witnessed a remarkable rise in the quantity of medications dispensed in community settings. Utilization of chronic disease medications has increased in the past 15 years, specifically, dispensed medications for the cardiovascular system, central nervous system, and endocrine system. It is necessary to conduct additional cohort studies to investigate the clinical outcomes and prescribing safety of these medications.