joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
7.3 Learning Disabilities
7.3.1 Diagnosed and Modelled Prevalence,
As part of the Quality and Outcomes Framework (QOF), general practices compile
disease and medical condition registers. From these registers, the prevalence of these
various conditions can be estimated. However, there may be a high proportion of
patients who have the disease or medical condition, but it is undiagnosed and the
patient is not included on the register(s). Furthermore, the figures are unadjusted for
influencing factors, such as the age of the patients and deprivation. Practices with a
high proportion of elderly patients and practices in the most deprived areas will tend to
have a higher prevalence of disease (and generally a higher prevalence of undiagnosed
disease) so practices have been grouped based on age and deprivation into similar
groups (see section 3.3.3.3 on page 47). See section 12.13 on page 782 for more
information on QOF and issues associated with presenting the prevalence at practice
level. Also see Table 49 for mean deprivation scores for each practice (which will
influence the prevalence on the disease registers). There is one such register for
learning disabilities for those aged 18+ years, and for this condition specifically, there is
no reason to suppose that the prevalence will increase with increasing age of the
practice patients (unlikely the majority of the other QOF registers).
Table 58 presents the information for learning disabilities for patients aged 18+ years for
all the general practices in Hull for 2009/10. Frequently the QOF „prevalence‟ figures
are presented out of the total registered population, but this is not an accurate measure
of prevalence in the population if it differs from the numerator. The numerator for
learning disabilities is the number of people aged 18+ years who have learning
disabilities, so the denominator also uses the population aged 18+ years. The QOF
takes the prevalence as at 31 st March 2010 and the practice population as at 1 st January
2010, therefore, there can be a biased prevalence estimate if the practice population
has changed considerably over the three month period (such as new practices).
The latest list size refers to the registered population as at 1 st January 2010, but the
number and prevalence on the disease register is as at 31 st March 2010 (the same
definitions used in QOF), and this means that the prevalence can be biased if large
population changes have occurred over this three month period (e.g. Y02747, Y02786,
Y02896 and Y02748 all opened between 5 th October 2009 and 11 th January 2010).
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 158