Dataset Information

Geographical inequalities in uptake of NHS funded eye examinations: Poisson modelling of small-area data for Essex, UK.

ABSTRACT:

Background

Small-area analysis of National Health Service (NHS)-funded sight test uptake in Leeds showed significant inequalities in access among people aged <16 or ?60.

Methods

Data were extracted from 604 126 valid General Ophthalmic Services (GOS)1 claim forms for eye examinations for Essex residents between October 2013 and July 2015. Expected GOS1 uptake for each lower super output area was based on England annual uptake. Poisson regression modelling explored associations in GOS1 uptake ratio with deprivation.

Results

People aged ?60 or <16 living in the least deprived quintile were 15% and 26%, respectively, more likely to have an NHS funded eye examination than the most deprived quintile, although all are equally entitled. GOS1 uptake is higher in the more deprived quintiles among 16-59-year old, as means tested social benefits are the main eligibility criteria in this age-group. Inequalities were also observed at local authority level.

Conclusions

Inequalities in access among people ?60 years were not as large as those reported in Leeds, although inequalities in <16-year old were similar. However, demonstrable inequalities in this data set over a longer time period and a larger and more diverse area than Leeds, reinforce the argument that interventions are needed to address eye examination uptake inequalities.

SUBMITTER: Shickle D

PROVIDER: S-EPMC6051445 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Geographical inequalities in uptake of NHS funded eye examinations: Poisson modelling of small-area data for Essex, UK.

Shickle Darren D Farragher Tracey M TM Davey Chris J CJ Slade Sarah V SV Syrett James J

Journal of public health (Oxford, England) 20180601 2

<h4>Background</h4>Small-area analysis of National Health Service (NHS)-funded sight test uptake in Leeds showed significant inequalities in access among people aged <16 or ≥60.<h4>Methods</h4>Data were extracted from 604 126 valid General Ophthalmic Services (GOS)1 claim forms for eye examinations for Essex residents between October 2013 and July 2015. Expected GOS1 uptake for each lower super output area was based on England annual uptake. Poisson regression modelling explored associations in ...[more]

PMID: 28633479

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Project description:BackgroundReducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions.ObjectivesTo provide estimates of the impact of a range of interventions on health and health inequalities.Materials and methodsLiterature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a 'living wage'; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII).ResultsIntroduction of a 'living wage' generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted.ConclusionsInterventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities.

Dataset Information

Geographical inequalities in uptake of NHS funded eye examinations: Poisson modelling of small-area data for Essex, UK.

Background

Methods

Results

Conclusions

Publications

Geographical inequalities in uptake of NHS funded eye examinations: Poisson modelling of small-area data for Essex, UK.

Similar Datasets

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