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Tools
to aid decision making
Helen Cooke SWPHO
Useful skills to acquire (if you
haven’t already
• Understand the principles of a spine chart
• Understand how to use Instant Atlas tools
• Health Profiles
• APHO Inequalities Toolkits
– Internal inequalities in all Local Authorities
• Tools for JSNA and others
• Prevalence models (commissioning toolkits)
• Slope Index of inequality
• Programme budgeting tool
Health Profiles
• One of the most valuable resources – separate session
• Compact 4-page document or electronic
• Local Authority level
• Trends
• Ethnicity
• 30 indicators on wider determinants
• Interpretation provided
• Also visualised through Instant Atlas
• http://www.apho.org.uk/default.aspx?RID=49802
Sexual Health Balanced Scorecard
http://www.apho.org.uk/sexualhealthbalancedscorecard
Bournemouth
and Poole has
the highest
rates of HIV in
the South
West
http://www.injuryobservatory.net/
http://www.chimat.org.uk/
Outcomes versus Expenditure Tool - Maternity and Newborn
Total expenditure on maternity services per birth compared to percentage of women
smoking at delivery, 2008/09
12.7
http://www.nwph.net/alcohol/lape/
Local Alcohol Profiles for England
Selection from Torbay profile
http://www.noo.org.uk/
APHO inequalities tool for all areas
Models the life expectancy gap between the most deprived
quintile of any Local Authority and:
• The local authority as a whole
• The least deprived quintile in the local authority
• The remainder of the local authority (ie the local authority without the
most deprived quintile)
• England as a whole
• England's least deprived quintile
you can then model interventions either across the most
deprived quintile or the authority as a whole
• www.lho.org.uk/LHO_Topics/Analytic_Tools/HealthInequalitiesAllAreas2008.aspx
Breakdown of life expectancy gap between the Most Deprived
Quintile (MDQ) of Penwith and England average by cause of death
Life expectancy years gained if the Most Deprived
Quintile (MDQ) of Penwith CD had the same mortality
rate as the England average for each cause of death.
Local Tobacco Control Profiles for
England
/lhostaging.hyperspheric.com/LHO_Topics/Analytic_Tools/TobaccoControlProfiles/default.aspx
tobacco control regional profile
JSNA interactive mapping tool
• Many JSNA indicators for all Local Authorities
in England
http://www.swpho.nhs.uk/tools/35106/atlas.swf
http://www.swpho.nhs.uk/tools/35106/atlas.swf
Future developments
• Awaiting APHO tool with national data
Slope index of inequality
http://www.apho.org.uk/resource/item.aspx?RID=75019
PCT Spend and Outcome Factsheets
and Tool (SPOT)
• Programme Budgeting is a well-established technique for
assessing investment in programmes of care rather than
services.
• Allows easy identification of those areas which require
priority attention, where relative potential shifts in
investment opportunities will optimise local health gains and
increase quality.
• The ability to link expenditure and outcome is explicit in two
of the World Class Commissioning competencies; '6 prioritise
investment' and '11 make sound financial investments'.
http://www.yhpho.org.uk/resource/view.aspx?RID=49488
Extract from CIOS programme budgeting report
APHO Disease prevalence models
• http://www.apho.org.uk/resource/view.aspx?RID=48308
• Cancer
Chronic Kidney Disease
Chronic Obstructive Pulmonary Disease
Coronary Heart Disease
• Dementia
• Diabetes
• Hypertension
• Mental Illness
• Stroke
https://www.cancertoolkit.co.uk/PublicPages
Learning Tools and Resources
Health Knowledge
LSHTM – Introductory Epidemiology Course
CAST – Computer Assisted Statistical Teaching
Health Knowledge
Public Health Textbook
E Learning Modules
Interactive Learning
Teaching
www.healthknowledge.org.uk/interactivelearning/index.asp
LSHTM – Introductory Epidemiology Course
Internet based application
Costs £60 (three months)
Interactive content
Self assessment exercises
Certificate upon completion
http://www.lshtm.ac.uk/prospectus/cpd/fundamentals_epi.html
CAST – Computer Assisted Statistics Teaching
Highly interactive statistics teaching tool
Ranged from elementary to advanced
Contains a biometric statistics set of modules
Self assessment exercises
Web based or downloadable
Available from http://cast.massey.ac.nz

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Tools for Public Health Decision Making

  • 1. Tools to aid decision making Helen Cooke SWPHO
  • 2. Useful skills to acquire (if you haven’t already • Understand the principles of a spine chart • Understand how to use Instant Atlas tools
  • 3. • Health Profiles • APHO Inequalities Toolkits – Internal inequalities in all Local Authorities • Tools for JSNA and others • Prevalence models (commissioning toolkits) • Slope Index of inequality • Programme budgeting tool
  • 4. Health Profiles • One of the most valuable resources – separate session • Compact 4-page document or electronic • Local Authority level • Trends • Ethnicity • 30 indicators on wider determinants • Interpretation provided • Also visualised through Instant Atlas • http://www.apho.org.uk/default.aspx?RID=49802
  • 5.
  • 6.
  • 7. Sexual Health Balanced Scorecard http://www.apho.org.uk/sexualhealthbalancedscorecard
  • 8. Bournemouth and Poole has the highest rates of HIV in the South West
  • 11. Outcomes versus Expenditure Tool - Maternity and Newborn Total expenditure on maternity services per birth compared to percentage of women smoking at delivery, 2008/09 12.7
  • 15. APHO inequalities tool for all areas Models the life expectancy gap between the most deprived quintile of any Local Authority and: • The local authority as a whole • The least deprived quintile in the local authority • The remainder of the local authority (ie the local authority without the most deprived quintile) • England as a whole • England's least deprived quintile you can then model interventions either across the most deprived quintile or the authority as a whole • www.lho.org.uk/LHO_Topics/Analytic_Tools/HealthInequalitiesAllAreas2008.aspx
  • 16. Breakdown of life expectancy gap between the Most Deprived Quintile (MDQ) of Penwith and England average by cause of death
  • 17. Life expectancy years gained if the Most Deprived Quintile (MDQ) of Penwith CD had the same mortality rate as the England average for each cause of death.
  • 18. Local Tobacco Control Profiles for England /lhostaging.hyperspheric.com/LHO_Topics/Analytic_Tools/TobaccoControlProfiles/default.aspx
  • 20. JSNA interactive mapping tool • Many JSNA indicators for all Local Authorities in England http://www.swpho.nhs.uk/tools/35106/atlas.swf http://www.swpho.nhs.uk/tools/35106/atlas.swf
  • 21. Future developments • Awaiting APHO tool with national data
  • 22. Slope index of inequality http://www.apho.org.uk/resource/item.aspx?RID=75019
  • 23. PCT Spend and Outcome Factsheets and Tool (SPOT) • Programme Budgeting is a well-established technique for assessing investment in programmes of care rather than services. • Allows easy identification of those areas which require priority attention, where relative potential shifts in investment opportunities will optimise local health gains and increase quality. • The ability to link expenditure and outcome is explicit in two of the World Class Commissioning competencies; '6 prioritise investment' and '11 make sound financial investments'. http://www.yhpho.org.uk/resource/view.aspx?RID=49488
  • 24. Extract from CIOS programme budgeting report
  • 25.
  • 26. APHO Disease prevalence models • http://www.apho.org.uk/resource/view.aspx?RID=48308 • Cancer Chronic Kidney Disease Chronic Obstructive Pulmonary Disease Coronary Heart Disease • Dementia • Diabetes • Hypertension • Mental Illness • Stroke
  • 28. Learning Tools and Resources Health Knowledge LSHTM – Introductory Epidemiology Course CAST – Computer Assisted Statistical Teaching
  • 29. Health Knowledge Public Health Textbook E Learning Modules Interactive Learning Teaching www.healthknowledge.org.uk/interactivelearning/index.asp
  • 30. LSHTM – Introductory Epidemiology Course Internet based application Costs £60 (three months) Interactive content Self assessment exercises Certificate upon completion http://www.lshtm.ac.uk/prospectus/cpd/fundamentals_epi.html
  • 31. CAST – Computer Assisted Statistics Teaching Highly interactive statistics teaching tool Ranged from elementary to advanced Contains a biometric statistics set of modules Self assessment exercises Web based or downloadable Available from http://cast.massey.ac.nz

Notas del editor

  1. We have already looked at some primary data sources, and some very simple prepared data. Over the last few years many more tools have appeared which (in theory at least) cut out some of the tedium from our jobs and allow us to do more thinking This is a quick tour of the major tools
  2. Although produced by SWPHO, it contains data for every local authority in England. Also on HES website is HES data similarly mapped, but for the South West only. Other Observatories have similar interactive websites.
  3. Why do we need prevalence moodels instead of relying on RECORDS OF TREATMENT (MORTALITY, HES, QOF) Prevalence models Comparisons of national prevalence data from the Health Survey for England (HSE) and recorded prevalence from the Quality & Outcomes Framework (QOF) suggest that there is considerable under-diagnosis (in terms of IT system recording) of risk factors and diseases. This is probably due to under-recording of cases already known to practices, and lack of information in a proportion of cases, where patients may have been diagnosed previously by other practices or hospital consultants.