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
the Diabetes Equity Audit, the percentage of the registered population living in the most
deprived quintile areas (with quintiles defined on a national basis) ranged from 10% to
92% for the general practices in Hull. It is likely that this could affect the results of the
modelling. However, whilst more up-to-date data could be entered into the Phase 2
model, the model produces estimates for 2001 which are considerably lower (between
40% and 60% lower) than the current model estimates which relate to estimates for the
year 2010.
In the current model (downloaded January 2011), it is necessary to specify the number
of people in each age, gender and ethnicity group for the geographical area or
population the user wishes to examine. The current model uses 10 year age bands (16-
24, 25-34, ..., 65-74 and 75+) with Black and Minority Ethnic (BME) groups defined on
the basis of three groups (White, Mixed and Other combined, Black or Black British, and
Asian or Asian British). The numbers by BME group are not known at practice level, but
can be estimated using the same methodology used in the Diabetes Equity Audit.
Further information about the PBS model and estimating ethnicity at practice level is
available in section 12.14 on page 784.
The results of the modelling and the actual diagnosed numbers of patients with diabetes
are given in Table 273 for the current model. The current model provides estimates for
those aged 16+ years, but the QOF relates to those aged 17+ years. However, there
will be very few patients aged 17 years with diabetes for each practice so it is unlikely to
influence the calculations, and the fact that the population ages differ has been ignored
for simplicity. The model does not necessarily represent the actual total (undiagnosed
and diagnosed) number of people who should have diabetes for each practice; it is only
a guide. The characteristics of each practice differ and need to be considered.
Using the current PBS model, it is estimate that there are 16,645 patients with diabetes
registered with Hull practices as at 2010. However, the number on the GP disease
registers is 12,279. If the model is a good estimate of the prevalence of diagnosed and
undiagnosed diabetes then this would mean there are 4,366 patients with undiagnosed
diabetes. The current prevalence is 5.29% whereas the prevalence estimated by the
model is 7.17%.
As the current model does not adjust for deprivation at practice level, but only overall
(assuming the distribution of the national deprivation quintiles for Hull applies to all
practices), the model is likely to give less influence to deprivation in the most deprived
practices and more influence to deprivation in least deprived practices.
The prevalence on the disease registers used to form the official QOF information is
extracted from the Quality Management and Analysis System (QMAS) at the end of
March. However, this information can be extracted at any time point from the local
QMAS system and the information in Table 273 gives this information as at September
2010.
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 570