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Measuring morbidity for resource allocation.

¹Department of Community Medicine, United Medical School, Guy's Hospital, London.

British Medical Journal (Clinical Research Ed.)

|September 19, 1987

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Standardised mortality ratios (SMRs) were used to allocate healthcare resources, but their accuracy as a proxy for morbidity is debated. Mortality data correlate with morbidity and deprivation, though comprehensive data are needed for conclusive evidence.

Area of Science:

Health Services Research
Epidemiology
Public Health Policy

Background:

The Resource Allocation Working Party (RAWP) report utilized standardized mortality ratios (SMRs) to estimate healthcare needs across geographical areas.
SMRs aimed to account for differences in morbidity by adjusting for population age and sex structure.

Purpose of the Study:

To evaluate the adequacy of SMRs as a proxy for morbidity in healthcare resource allocation.
To address controversies surrounding SMRs and explore alternative morbidity measures.

Main Methods:

Analysis of the relationship between SMRs, morbidity, and social deprivation.
Critique of alternative morbidity proxies based on social indicators.
Examination of the correlation between mortality data and measures of morbidity and social deprivation.

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Main Results:

SMRs have been controversial, with critics questioning their link to morbidity and their failure to account for social deprivation.
Alternative social indicators as morbidity proxies are limited by their correlation with service utilization, which is supply-dependent.
Existing evidence shows mortality data correlate well with available morbidity and social deprivation measures.

Conclusions:

SMRs possess merits as health need measures, being independent of service supply and more direct indicators of health status than social indicators.
The debate on SMRs' adequacy remains inconclusive without comprehensive morbidity data.
Mortality data offer a valuable, albeit imperfect, proxy for health needs in resource allocation.