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
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.
This model estimates the number of people with COPD by assuming the prevalence of
COPD for each gender and age band based on estimates produced by systematic
reviews and examination of the General Practice Research Database (step 1), adjusting
the resulting estimates by the all age COPD mortality ratio (e.g. Hull‟s COPD 2005-2007
SMR was 159 so the stage 1 numbers would be increased by 59% (step 2) and by then
adjusting the resulting estimates by a deprivation score (UV67 derived from 2001
Census information) produced at practice level (step 3). This practice deprivation score
(from step 3) is first divided by the „expected‟ (UV67) score for Hull to avoid „doublecounting‟
the effect of deprivation (step 2 and step 3 both adjusted for deprivation).
Halbert et al (Halbert, Isonaka et al. 2003) undertook a systematic review of COPD
prevalence from 32 studies from across the world mainly based in the US or Europe.
The prevalence estimates varied widely from 1% to 18%. Soriano et al (Soriano, Maier
et al. 2000) have also produced some estimated prevalence figures from the General
Practice Research Database, which were 1.7% for males and 1.4% for females (so at
the lower end of the scale in relation to Halbert‟s estimates), Soriano considers that they
are a reasonably good indicator of levels of physician diagnosed COPD in the UK.
Soriano provided prevalence rates for men and women but not by age group, although it
is suggested that the age distribution is broadly in range in relation to 1991-1992 data
from the Morbidity Statistics from General Practice, i.e. consultancy rates (Office for
Population Censuses and Surveys 1995). The prevalence estimates used in the model
uses the age-specific rates from the Morbidity Statistics but increased them in-line with
Soriano‟s reported overall prevalence rates.
The results of the modelling and the actual diagnosed numbers of patients with COPD
are given in Table 298. The model does not necessarily represent the actual number of
people who should be diagnosed with COPD for each practice; it is only a guide. The
characteristics of each practice differ and need to be considered. Furthermore, it does
not include undiagnosed cases of COPD.
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 298 gives this information as at September
2010.
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 617