1. Housing Dept Vol Sector NHS RSLs

2. Linkage of Hospital data and HL1 data in the Kingdom of Fife Neil Hamlet, CPHM neil.hamlet@nhs.netneil.hamlet@nhs.net Bryan Archibald, Senior Information Officer barchibald@nhs.netbarchibald@nhs.net Bryan Archibald barchibald@nhs.net

3. The Data Sources Fife Council HL1 National data set for each homeless application Based on the application (not the number of homeless individuals) NHS Fife Acute Hospitals eOASIS (patient administration system) SMR data submitted to ISD Based on Patient Episodes

4. HL1 Data Linkage Variable 1.GEORGEBLOGGS19900101F 2.GEBLOGGS19900101F 3.GEBLOG19900101F 4.GEBLOG1990010F 5.GEORBLOGGS19900101F 6.GEORBLOG19900101F 7.GEORBLOG1990010F Name – George Bloggs Date of Birth – 1990/01/01 Sex - Female

5. NHS Data (OASIS) A&E (MIU) Inpatients & Day cases Obstetrics Mental Health Inpatients Outpatients Mental Health Outpatients

6. Population George Bloggs En: 31/12/2007 Ex: 01/01/2008 2007 & 2008 Mary Christmas En: 01/01/2008 Ex: 02/02/2008 En: 01/09/2008 Ex: 31/12/2008 2008 only

7. Linkage Issues

8. Population Issues

9. Areas of study A&E Admissions Obstetric Admissions Psychiatric Admissions

10. Results – A&E

11. Results – Inpatients & Day cases

12. Results – Obstetrics

13. Results – Outpatients

14. So far so good but what does this mean? We need a comparatorWe need a comparator Fife’s ‘securely - housed’ populationFife’s ‘securely - housed’ population Try to compare by similar age profileTry to compare by similar age profile Started with Fife population 15-64 as our crude method of ‘standardisation’Started with Fife population 15-64 as our crude method of ‘standardisation’ Further refinements planned in ‘standardisation process’Further refinements planned in ‘standardisation process’ Aiming to compare ‘apples’ with ‘apples’ by security of housing as defined by HL1 registrationAiming to compare ‘apples’ with ‘apples’ by security of housing as defined by HL1 registration

29. Inverse Care Law The availability of good medical care tends to vary inversely with the need for it in the population served.” “ The availability of good medical care tends to vary inversely with the need for it in the population served.” “Those who need healthcare least use the services more, and more effectively, than those with the greatest need and those people in the worst health receive the least services.” Julian Tudor Hart 1971