Illustrating the Concept of Unmet Need Acute MLC sub-group: 2 nd October 2014

Outline: Description of the issue; Use of spline functions; Other methods; Questions.

x x xxxx xx xxxx xx xxxxxx xxxx xxxx xxxxxx xxxxx xxxxx xxx xxxxx xxx x All need manifests in utilisation Utilisation Indicators of need

x x xxxx xx xxxx xx xxxxxx xxxx xxxx xxxxxx xxxxx xxxxx xxx xxxxx xxx x Deviation from full utilisation Utilisation Indicators of need

x xxxx xxxxxx x xxxxxx xxxxxx xxxxx xxxxxx xxxxxx xxxxx xxxxx xxxxx Unmet need Utilisation Indicators of need

x xxxx xxxxxx x xxxxxx xxxxxx xxxxx xxxxxx xxxxxx xxxxx xxxxx xxxxx Testing for unmet need – spline functions Utilisation Indicators of need Lower cut-off Upper cut-off

x xxxx xxxxxx x xxxxxx xxxxxx xxxxx xxxxxx xxxxxx xxxxx xxxxx xxxxx Adjusting for unmet need – spline functions Utilisation Indicators of need Lower cut-off Upper cut-off

NRAC Adjustment for unmet need – Circulatory Utilisation Indicators of need Upper cut-off – 75% deprivation

0 X 0x00 xx 0x0X X0 00x0X0 x0X xxx0x x0x00 00xxx 000 0xx0x 0x0 x Using SHeS: step one - estimating prevalence Prevalence Indicators of need

x xxxx xxxxxx x xxxxxx xxxxxx xxxxx xxxxxx xxxxxx xxxxx xxxxx xxxxx Using SHeS: step two – utilisation on prevalence Utilisation Prevalence Lower cut-off Upper cut-off

Other techniques: Variations method; Counter-intuitive signs; Variations method II.

Questions: what other research is relevant and should be taken into account; what priority should be given to alternative approaches; how relevant is the question of determinants; what evidence is there on determinants?

Illustrating the Concept of Unmet Need Acute MLC sub-group: 2 nd October 2014