Webber, R; (2004) Neighbourhood inequalities in the patterns of hospital admissions and their application to the targeting of health promotion campaigns. (CASA Working Papers 90). UCL (University College London), Centre for Advanced Spatial Analysis (UCL): London, UK.

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Abstract

For many years indicators of deprivation have played a pivotal role in the processwhereby government assesses the relative level of resources require to meet local healthneeds. The formulae that have been developed for this purpose recognise that the locallevel of need for health resources varies among different population groups, such as theelderly or people with young children1. The formulae also recognise the strength of therelationship between health and deprivation. O ver a hundred years ago public healthofficials first recognised differences in the rates of mortality among different occupations.Likewise today?s funding formulae recognise the especial needs of local areas with highproportions of particular ly deprived groups such as overcrowded households, personswithout access to a car or people who are unemployed. As the focus of the health serviceincreasingly extends beyond the treatment of patients to an attempt to improve the healthof local populations through preventative campaigns, the focus of targeting extendslikewise to the identification of neighbourhoods at highest risk of particular diagnoses.To this end the National Health Service has recently commissioned a number of pilotexercises2 to assess the effectiveness of postcode classification systems in the targettingof health promotiona l material. In order to assess which types of neighbourhood are mostsuitable for specific communications programmes, the Hospital Episode Statistics haverecently been coded by Mosaic, the UK?s most widely used postcode classificationsystem. This paper summarises the key differences that have been found to exist betweenthese Mosaic types, both in terms of overall level of admissions and type of diagnosis.The paper also evaluates the extent to which the classification system may be an efficientmethod not just of targeting specific health campaigns but also for assessing levels ofneed by type of service at a highly local level.

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