Health Poverty Index (hpi) visualisation tool: Indicator Descriptions

All Indicators > Indicator SR1: Health care resourcing

Definition	Net health care expenditure (inpatient and outpatients) per capita for medical, surgical and psychiatric specialties
Dimension	Situation of health
Sector	Resourcing for health and social care
Components	SR1_1 Spend on medical specialties SR1_2 Spend on surgical specialties SR1_3 Spend on psychiatric specialties
Source Numerator	2001, 2001 Ethnic: Annual Financial Returns of Financial Trusts, form TFR2D, sheets 058 (patients using a bed) and 063 (outpatients), 2001/02 financial year, Department of Health
Source Numerator	2003: Annual Financial Returns of Financial Trusts, form TFR2D, and Primary Care Trusts, form PFR2D, sheets 058 (patients using a bed) and 063 (outpatients), 2003/04 financial year, Department of Health
Source Denominator	2001, 2001 Ethnic: Mid year population estimate 2001, ONS
Source Denominator	2003: Mid year population estimate 2003, ONS

Additional details

Inpatient and outpatient net expenditure on medical, surgical and psychiatric specialties was summed for each Trust (columns A, B and D from sheets 058 and 063).

As regional resources, it is not possible to differentiate access by ethnic group. Thus all ethnic groups are attributed the same expenditure.

Expenditure was distributed to Local Authority Districts (LAD) using two methods as outlined below. Values from the two methods were then summed:

Method 1 – Using Hospital Episode Statistics (HES)
This methodology was used where a Trust code could be linked to the Department of Health’s HES dataset for 2001. The HES dataset was used to distribute expenditure to wards using the Norris Bailey proportionate flow methodology for creating NHS trust catchment populations. This is described in a methods document published by the Eastern Region Public Health Observatory (Eastern Region Public Health Observatory. Catchment areas and populations. INphoRM (Information on Public Health Observatory recommended methods) February 2003, Issue 2) and outlined below:

Trust expenditure was allocated pro rata to a ward based on the proportion of episodes from that ward to each provider.

Ea = W1a E1 / Sum(W1i) + W2a E2 / Sum(W2i)

Where:
Ea = expenditure ward a
W1a = ward activity provider 1
W2a = ward activity provider 2
E1 = expenditure provider1
E2 = expenditure staffing provider 2 etc
W1i = total activity in provider 1
W2i = total activity in provider 2 etc

Data were then aggregated to LAD level.

Method 2 – Using Primary Care Trust (PCT) catchments
This method was used for Trusts that could not be linked to the HES dataset. Expenditure was allocated to PCTs as shown:

2001
Trust code	Trust name	PCT code	PCT name
RBP	Chester and Halton Community NHS Trust	5J1	Halton PCT
RER	St Helens and Knowsley Community Health NHS Trust	5J3	St Helens PCT
RJM	Walsall Community Health NHS Trust	5M3	Walsall Primary Care Trust
RJT	Cheshire Community Health Care NHS Trust	5H4	Central Cheshire PCT
RPV	Riverside Community Health Care NHS Trust	5H1	Hammersmith and Fulham PCT
RA0	Croydon and Surrey Community NHS Trust	5K9	Croydon PCT
RNK	Tavistock and Portman NHS Trust	5A9 5K7 5C1 5C9 5K8	Barnet PCT Camden PCT Enfield PCT Haringey PCT Islington PCT

2003
Trust code	Trust name	PCT code	PCT name
RNK	Tavistock and Portman NHS Trust	5A9	Barnet PCT
		5K7	Camden PCT
		5C1	Enfield PCT
		5C9	Haringey PCT
		5K8	Islington PCT

Data were attached to the Postcode Address File linking on PCT of residence for each postcode. This allowed a population weighted value to be created for each LAD.

Further Information

The HPI tool is in the third phase of development. We would welcome your feedback.

Please remember to reference the project if you use the data or charts from this site.

Dibben, C, Sims, A., Watson, J., Barnes, H., Smith, T., Sigala, M. , Hill, A. and Manley, D. (2004) The Health Poverty Index. South East Public Health Observatory, Oxford.

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