Comparison of provision and need for publicly-funded personal health services

To determine whether health services have been purchased equitably according to population needs at the territorial local authority (TLA) level.

The project involved the mapping of different categories of personal health service expenditure onto TLA areas. The measure used to compare provision and need was the ratio of observed to expected expenditure. Need beyond weighted populations by age, sex, and ethnicity or community services card status was measured using standardised mortality ratios.

The analysis did not suggest that the inverse care law was operating at the level of TLAs. There was no systematic bias against equity. However there is a good deal of scatter in the plots, some of which will be accounted for by data quality problems, and some of which is possibly due to inequitable purchasing.

The inverse care law does not appear to be operating at the level of TLA. The methods piloted in this study represent a useful way of analysing and presenting information on resource allocation. Deficiencies in data quality limit the strength of conclusions which can be drawn from this project. More specific observations could be made if the methods used here were applied to smaller areas, and data quality issues were addressed.