Applying Model Of Needs To Planning Effective Healthcare Systems

1313 words - 6 pages

In order to define the need of health care and planning appropriate health care system, population level model of needs should be applied. The relationship between poverty and ill health has been researched for more than 100 years(scotch NHS web) and repeated studies have shown a strong relationship between material deprivation, poor health and the need for health care services (course material). In general terms more socially deprived populations experience more ill-health and also underutilize the health care system. There is therefore a role for population-based indicators of need to include some measure of social deprivation as this will capture an element of need for ...view middle of the document...

Tha main adventage of such area based analysis is examining health data based on individual events which contain a postcode reference (Scottish NHS web).

Geodemographics: is the grouping of people in geographic areas according to their socio-economic characteristics. Ggeodemographic data are referenced to small areas, a small area being an administrative unit typically with a population of less than 10,000. Many geodemographic data sets provide counts of the numbers of households of a particular type resident within a given small area. The small areas generally follow either census or postal geographies. Such geodemographic classifications can help identify the demand for healthcare (Petersen et al, 2010), particularly in private insurance or market-based systems. Geodemographic classifications may help identify those households with private medical insurance, or those groups who have the financial resources to access more expensive, private forms of healthcare.

Carstairs score: In the 1980s Vera Carstairs and Russell Morris developed this index designed to be used for health analysis which would measure material deprivation in small areas. It is an unweighted combination of four variables that are unemployment, overcrowding, car ownership and low social class (Social Class IV and V) (Morgan and Baker’s, 2006). The scores are a summary measure applied to populations contained within small geographic localities.( Philip McLoone, 2001 ).

Overcrowding Persons in households with one or more persons per room as a proportion of all residents in households.
Male unemployment Unemployed males 16 and over as a proportion of all economically active males aged 16 and over.
Low social class Residents in households with an economically active head of household in Social Class IV or V as a proportion of all
residents in households.
No car Residents in households with no car as a proportion of all residents in households
Table 1: Variables from 2001 Census used in Carstairs Index. Source Morgan and Baker, 2006.

Each variable is standardised (z-scored) to avoid the score being unduly influenced by a high or low value for any one variable and to put each variable on the same scale, centred around zero. Standardized scores are produced for each of the four Carstairs variables by subtracting the national mean and dividing by the national standard deviation; these standardized scores are then summed to produce the combined index.

Zi = (Xi-Mi)/Si;

i =1,2,3,4; Xi= variables; S = standard deviation of variable; Mi = national mean of variable

Carstairs score is defined as the multiple of four standardized scores of four variables.


Bigger the Carstairs score, greater the deprivation will be.

Limitation of Carstairs index: There are possible limitations in use of Carstairs Score index. For instance:
1. likely to provide better indication of deprivation in urban than rural areas because of populations in the rural area contain mixture of...

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