Transcript Document

Vital statistics
Mortality (07/02/02)
Morbidity (21/02/02)
Hannes Botha
(Dr JL Botha)
Director, Trent Cancer Registry
Hon Senior Lecturer
[email protected]
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Morbidity - Outline
• Sources
– Birth to death
– Illness episodes
• Uses
– Interpretation of trends
– Clues to causes
– Identification of health/care needs
• Handout
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Sources
Death
Birth
Birth
registration
Marriage
registration
Death
registration
Child health
Vaccinations
Congenital malformations
Decennial Census
General Household Survey
Social security
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Sources
Onset
Outcome
Symptoms
Diagnosis
Treatment
Screening
GP:
Age- sex registers
Consultations
Prescriptions
Hospitals:
Activity
Performance
Disease registration/notification:
Cancer
Communicable diseases
Community services
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Information on the WWW
• National Statistics
– Population
– Morbidity data
• Department of Health
– Waiting lists
– Performance
• Others
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Interpretation of trends
Incidence of Childhood Diabetes in
Leicestershire 1950-1996
Rate per
100,000/year
25
20
15
10
5
1995
1990
1985
1980
1975
1970
1965
1960
1955
1950
0
Calendar year
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Interpretation of trends
• Chance
• Artefactual
– Numerator
– Denominator
• Real
– ‘Natural’ (epidemiological)
– Medical care effects
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Clues to causes
CHD trends
Rate/100,000
180
160
140
120
100
80
60
Sweden
40
USA
20
1947
1945
1943
1941
1939
1937
1935
0
Year
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Clues to causes
Consumption in Sweden
25
Kilograms
20
15
10
5
Total fat
Milk and cream
Eggs
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
0
Year
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Health / Care needs (i)
• Self reported long standing illness GHS
• NHS expenditure
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Self reported long standing illness
By condition *
Great Britain, all persons, 1988
Other complaints 18%
27% Musculoskeletal
system
Ear complaints 5%
Eye complaints 5%
Nervous system 6%
17% Heart & circulatory
Digestive system 7%
Respiratory system 16%
* Data used are of self-reported illness
Percentages may not add up to 100 due to rounding
Source: General Household survey
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NHS expenditure
By diagnostic group
England and Wales, all persons
Other 10%
20% Mental
Genitourinary 4%
Pregnancy 5%
Digestive 5%
13% Circulatory
Respiratory 6%
Musculoskeletal 7%
9% Nervous system
Cancer 7%
Ill-defined 7%
7% Injury etc
Source: OPCS (HIPE 1982) Routine NHS costing returns 1986/7
National Morbidity Survey 1981/2
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Health / Care needs (ii)
Cancer Registration data
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Cancer Registrations E&W 1997
Other
NHL, Myeloma
Major tumour sites
Bladder
Prostate
Males
Ovary
Females
Uterus
Cervix
Breast
Melanoma of skin
Lung
Pancreas
Colorectal
Stomach
Oesophagus
0
5
10
15
20
25
30
35
Thousands
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Female breast cancer incidence in England
350
35-39
45-49
55-59
65-69
250
200
150
100
50
1997
1995
1993
1991
1989
1987
1985
1983
1981
1979
1977
1975
1973
0
1971
Rate per 100,000
300
40-44
50-54
60-64
70-74
Year of diagnosis
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Lung cancer incidence in Trent
100
80
Female
60
Male
40
20
1995
1994
1993
1992
1991
1990
1989
1988
1987
0
1986
Age standardised rate per 100,000
120
Middle Year
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Female breast cancer in Trent
100
1985-87
1989-91
1986-88
1990-92
1987-89
1991-93
1988-90
% 5-yr Relative survival
80
60
40
20
0
Derby CN
Leics CN
MTCN
NTCN
Cancer netw ork
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Male lung cancer in Trent
100
1985-87
1989-91
1986-88
1990-92
1987-89
1991-93
1988-90
% 1-yr Relative survival
80
60
40
20
0
DerbyCN
LeicsCN
MTCN
NTCN
Cancer netw ork
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Breast cancer in Trent Women
100
Affluent
2
3
4
Deprived
% 5-year Relative Survival
80
60
40
20
0
1971-75
1976-80
1981-85
1986-90
Incidence cohort
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An Information Strategy for the Modern NHS
1998–2005
• ‘2.7 …… a move towards an electronic record ……’
• ‘2.10 Electronic Patient Record (EPR) …… record of periodic
care provided mainly by one institution ……’
• ‘2.11 …… Electronic Health Record (EHR) …… a longitudinal
record of patient’s health and healthcare from cradle to grave…’
NHS Information Authority: http://www.nhsia.nhs.uk/
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