Equity of utilisation of cardiovascular care and mental health services in England: a cohort-based cross-sectional study using small-area estimation

Publication type

Journal Article

Authors

Publication date

May 15, 2016

Summary:

The aim of this project was to explore whether or not the extent to which people use NHS services for cardiovascular disease (CVD) and common mental health disorders (CMHDs) varies according to their personal characteristics and geographical location. This was done by comparing the number of people in different populations diagnosed with, and treated for, CVD and CMHDs with the estimated underlying number of people who have those conditions (based on a technique called small-area estimation). Disease prevalence estimates for practices, primary care trusts and Clinical Commissioning Groups were compared with (a) ‘presentation’ data on the number of adults registered by general practitioners as having diabetes, high blood pressure, coronary heart disease, stroke and depression; (b) expenditure on key drugs; (c) the number of people known to, or being treated by, community services (such as Improving Access to Psychological Therapies); and (d) the number of people receiving specialist interventions (such as elective and emergency admissions and surgical procedures). With respect to CVD, the estimates of underlying need accounted for a significant proportion of differential rates of use. Nevertheless, the analysis did yield evidence of some systematic inequalities in utilisation of CVD health care, particularly with respect to ethnicity. Rural (shire) areas also have notably low levels of cardiac care relative to need. For CMHDs, the overall picture is one of unexplained variation, although ethnicity again emerges as an important variable. There also appears to be a pronounced ‘London effect’, with rates of recorded disease and, particularly, prescribing being much lower than expected.

Published in

Health Services and Delivery Research

Volume and page numbers

Volume: 4 , p.1 -8

DOI

http://dx.doi.org/10.3310/hsdr04140

ISSN

20504349

Subjects

#524144

News

Latest findings, new research

Publications search

Search all research by subject and author

Podcasts

Researchers discuss their findings and what they mean for society

Projects

Background and context, methods and data, aims and outputs

Events

Conferences, seminars and workshops

Survey methodology

Specialist research, practice and study

Taking the long view

ISER's annual report

Themes

Key research themes and areas of interest