Sharing resources for health in England : report of the Resource Allocation Working Party.

  • Great Britain. Resource Allocation Working Party.
Date:
1976
Catalogue details

Licence: Open Government Licence

Credit: Sharing resources for health in England : report of the Resource Allocation Working Party. Source: Wellcome Collection.

    23/140 (page 21)
    lished by reference to the national figures of hospital bed utilisation for each condition category considered and incorporated in the calculation to provide the final link in the chain from mortality through morbidity to need for health services. 2.12 To each Region’s population we have applied national age/sex utilisation rates for each individual group of conditions, calculated a standardised mortality ratio for each group and combined the two weighting factors for each condition. The effect of doing this is to produce a set of weighting factors independent of Regional differences in the supply of NHS facilities and reflecting morbidity differences between different parts of the country over and above those resulting from age and sex disparities. The method ensures that, in applying SMRs by condition, account is taken of the proportionate national bed utilisation for each condition. Figure II-3 shows how the results compare with those of a population weighting based on hospital utilisation analysed by age and sex alone. 2.13 Asa result of the studies and analyses we have carried out, supported by the findings of research in related fields and expert advice, we have come to the conclusion that SMRs — adjusted in the way we propose — are the best available indicators of geographical variations in morbidity. And to ignore the considerable variations which this analysis displays would be to ignore a crucial factor in determining the relative needs for health care of different localities. 2.14 For certain conditions where mortality is very low — eg skin diseases and conditions of pregnancy -SMRs are unlikely to give a good guide to morbidity, and we have omitted these from our calculations. Age/sex weighting alone is a good indicator of the need for maternity services but it can be further improved by modifying the age/sex weighting for ICD Condition XI (conditions of pregnancy, childbirth, puerperium) to reflect fertility rates standardised for age, in the same way as other condition categories can be modified by SMRs. 2.15 There is evidence that other factors, eg marital status, are associated with the need for health care, but to add to those we have already proposed would strain the data to the point at which reliability was lost and incur a risk of double-counting. We recommend that, in respect of acute non- psychiatric hospital in-patient services, the population weighted for age and sex by national bed utilisation for each condition should be adjusted to take into account condition-specific SMRs for each Region. SMRs for Zl