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
Code Latest
list
size
Number and prevalence on atrial fibrillation QOF register over time
2006/07 2007/08 2008/09 2009/10
N % N % N % N %
B81027 5,976 90 1.52 95 1.59 87 1.45 87 1.46
B81040 16,805 123 0.73 121 0.71 134 0.79 140 0.83
B81047 7,377 77 1.05 75 1.04 71 0.98 67 0.91
B81089 3,583 25 0.75 25 0.74 25 0.70 30 0.84
B81631 3,425 11 0.35 11 0.34 10 0.29 12 0.35
B81683 1,644 8 0.52 9 0.62 16 1.06 21 1.28
Y02896 343 N/A N/A N/A N/A N/A N/A 4 1.17
B81017 6,800 88 1.22 83 1.15 89 1.31 82 1.21
B81018 6,602 52 0.77 50 0.74 41 0.61 51 0.77
B81032 2,478 19 0.69 18 0.66 21 0.80 14 0.56
B81046 9,068 65 0.72 69 0.79 79 0.88 91 1.00
B81692 1,814 1 0.05 1 0.06 3 0.17 1 0.06
Y00955 2,556 18 1.09 23 1.03 21 0.83 30 1.17
Y02748 60 N/A N/A N/A N/A N/A N/A 4 6.67
Doncaster PCT has created a model which can be used to produce the estimated
number of people with diagnosed atrial fibrillation (Doncaster PCT 2008). In general
when such models have been produced, the model is based on research undertaken
elsewhere in the UK examining the prevalence of diagnosed disease in the community,
which has then been modelled and applied to different populations such as those living
in a particular PCT area. Therefore, the accuracy of the estimates depend on the quality
of the initial research and the modelling itself. If the original research did not include
very deprived areas, it is very difficult to generalise and apply the model to very deprived
areas like Hull. Furthermore, there are many reasons why the prevalence could differ
among practices (see section 12.13 on page 782 for more information). Further
information about problems associated with models can be found in the Association of
Public Health Observatories Technical Briefing (Association of Public Health
Observatories 2011) and in section 12.1 on page 770. Therefore, just because
practices have a particularly low prevalence or a relatively large difference between the
registers and the model, it does not necessarily mean that they are performing badly in
any way relative to other general practices. Nevertheless, a comparison of the
differences between the modelled prevalence and the practice list registers can act as a
starting point for investigation. Practices with a low prevalence or a relatively large
difference between the model and the register estimates can be examined further and
considered in relation to patient characteristics using local knowledge. Differences
might just reflect that the model is not a very good fit for Hull. For reference, the mean
age of practice patients (Table 28) and mean deprivation scores (Table 49) for each
practice may be examined.
Doncaster PCT used prevalence rates for atrial fibrillation available from the Office for
National Statistics (Office for National Statistics 2005). The model used age-genderspecific
prevalence estimates for seven age groups (0-34, 35-44, 45-54, 55-64, 65-74,
75-84 and 85+ years) and did not adjust for ethnicity or deprivation in any way. The
results of the modelling and the actual diagnosed numbers of patients with atrial
fibrillation are given in Table 219. The model does not necessarily represent the actual
number of people who should be diagnosed with atrial fibrillation for each practice; it is
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 491