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Morbidity variation and RAWP.

R A Carr-Hill1, A Maynard, R Slack

  • 1Centre for Health Economics, University of York, UK.

Journal of Epidemiology and Community Health
|December 1, 1990
PubMed
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Using self-reported morbidity data for health resource allocation shows wider regional variations than standardized mortality ratios (SMRs). This highlights the need for clear definitions of health needs before implementing new weighting algorithms.

Area of Science:

  • Health economics
  • Public health policy
  • Healthcare resource allocation

Background:

  • Current English health resource allocations rely on population size adjusted by Standardised Mortality Ratios (SMRs).
  • The 'Working for Patients' White Paper suggests future allocations should use capitation adjusted by health measures.
  • This study explores the impact of incorporating morbidity data into these allocation algorithms.

Purpose of the Study:

  • To evaluate the effect of using self-reported morbidity data instead of SMRs in health resource allocation weighting algorithms.
  • To compare the regional variations in population weightings derived from morbidity data versus SMRs.

Main Methods:

  • Utilized data from the 1986 Health and Lifestyle Survey, encompassing all English health regions.

Related Experiment Videos

  • Employed three self-reported morbidity measures: Long Standing Illness, Any Declared Condition, and Any Handicap.
  • Calculated population weightings based on national average bed use for these conditions and SMRs.

    • Main Results:

    • All three morbidity measures indicated greater inter-regional variation compared to SMRs.
    • Population weightings derived from morbidity data showed approximately double the variation observed with SMRs.
    • This suggests morbidity data could lead to significantly different resource distribution.

    Conclusions:

    • Population weighting is critical for resource allocation in both hospital and primary care sectors.
    • The choice of morbidity measures for weighting algorithms may appear arbitrary without a consensus on defining "health need".
    • Further research and agreement on 'need' are essential for equitable resource distribution.