1. 21/02/02 1 Mortality (07/02/02) Morbidity (21/02/02) (Dr JL Botha) Director, Trent Cancer Registry Hon Senior Lecturer Hannes Botha blj @ le.ac.uk Vital statistics

2. 21/02/02 2 Morbidity - Outline Sources –Birth to death –Illness episodes Uses –Interpretation of trends –Clues to causes –Identification of health/care needs Handout

3. 21/02/02 3 Sources Birth Death Decennial CensusCensus Birth Birth registration Marriage registration Death registration Child health Vaccinations Congenital malformations General Household Survey Social security

4. 21/02/02 4 Sources Onset Outcome SymptomsDiagnosisTreatment Screening GP: Age- sex registers Consultations Prescriptions Hospitals: Activity Performance Disease registration/notification: Cancer Communicable diseases Community services

5. 21/02/02 5 Information on the WWW National StatisticsNational Statistics –PopulationPopulation –Morbidity dataMorbidity data Department of Health –Waiting listsWaiting lists –PerformancePerformance Others

6. 21/02/02 6 Interpretation of trends

7. 21/02/02 7 Interpretation of trends Chance Artefactual –Numerator –Denominator Real –‘Natural’ (epidemiological) –Medical care effects

8. 21/02/02 8 Clues to causes

9. 21/02/02 9 Clues to causes

10. 21/02/02 10 Health / Care needs (i) Self reported long standing illness - GHS NHS expenditure

11. 21/02/02 11 27% Musculoskeletal system 17% Heart & circulatory Ear complaints 5% Digestive system 7% Other complaints 18% Self reported long standing illness Great Britain, all persons, 1988 * Data used are of self-reported illness Percentages may not add up to 100 due to rounding Source: General Household survey Respiratory system 16% By condition * Eye complaints 5% Nervous system 6%

12. 21/02/02 12 20% Mental 13% Circulatory Digestive 5% Cancer 7% Pregnancy 5% NHS expenditure England and Wales, all persons Source: OPCS (HIPE 1982) Routine NHS costing returns 1986/7 National Morbidity Survey 1981/2 Ill-defined 7% By diagnostic group Respiratory 6% Musculoskeletal 7% 9% Nervous system 7% Injury etc Genitourinary 4% Other 10%

13. 21/02/02 13 Health / Care needs (ii) Cancer Registration data

14. 21/02/02 14

15. 21/02/02 15

16. 21/02/02 16

17. 21/02/02 17

18. 21/02/02 18

19. 21/02/02 19

20. 21/02/02 20 ‘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…’ An Information Strategy for the Modern NHS 1998–2005 NHS Information Authority: http://www.nhsia.nhs.uk/Information