Demographic aspects of resource allocation to health services

Slattery, Michael (1986) Demographic aspects of resource allocation to health services. University of Southampton, Doctoral Thesis.

Abstract

This thesis describes the application of demographic methods for resource allocation to the NHS. The inception and development of the NHS contributed to the unequal allocation of resources to regions and to districts within the same region. Subsequent allocation policies were slow to move from incremental funding and continued these inequalities. It is argued that the use of forecasts will lead to better planning, and methods are described for acute, geriatric and mental illness services, based on trend analysis of admission rates and the time spent in hospital. Standardised Mortality Ratios are discussed and new evidence is shown to support their use for acute hospital demand. Mental illness admission rates have fallen in younger age groups and in most disease groups but they have risen for the elderly and senile dementia. The prevalence of mental handicap is discussed, measured and used to describe possible future levels of demand for care. Expressions for the variance of products and quotients are derived and used to compare the methods which have been proposed for estimating the catchment population of a hospital; two new catchment methods are described. The value of occupational data is illustrated by a comparison of mortality due to cirrhosis of the liver and admission to mental illness hospital for alcoholism. (D72489/87)

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