Analysis of QMAS Disease Prevalence Data Kent & Medway

August 2005

Kent & Medway HIS

Produced by Helen Buttivant

Senior Public Health Information Analyst, Kent & Medway Health Informatics Service

Tel: 01622 793594 E-Mail: helen.buttivant@nhs.net

Contents of Report:

• Analysis of Disease Prevalence at 3 levels:

• National• PCT• Practice

• Evaluation of the QMAS data & comparison to other sources of Disease Prevalence

Kent & Medway HIS

Disease Prevalence at PCT Level

• Comparison of prevalence between PCTs for each individual condition

• Comparison of prevalence of every condition in each PCT

CHD Prevalence by PCT in Kent June 2005

0%

1%

2%

3%

4%

5%

Shepw ay East Kent

Coastal

Sw ale Canterbury and

Coastal

Ashford South West Kent DGS Maidstone Weald Medw ay

Dis

ease

Pre

vale

nce

PCT Rate (%)

K&M Rate (%)

England Rate (%)

Source: QMAS via HSCIC, June 2005

Disease Prevalence in Ashford & Shepway PCTs June 2005

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

HY

PE

RT

EN

SIO

N

AS

TH

MA

DIA

BE

TE

S

CH

D

HY

PO

TH

YR

OID

ISM

ST

RO

KE

/ T

IA

CO

PD

ME

NT

AL

HE

ALT

H

EP

ILE

PS

Y

CA

NC

ER

LVD

Pre

vale

nce

Ashford Shepway Kent & Medway England Source: QMAS via HSCIC, June 2005

Kent & Medway HIS

Kent & Medway HIS

CHD Prevalence by PCT in Kent June 2005

0%

1%

2%

3%

4%

5%

A B C D E F G H IPCT

Dis

ease

Pre

vale

nce

PCT Rate (%)

K&M Rate (%)

England Rate (%)

Kent & Medway HIS

Disease Prevalence in PCT A June 2005

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

HYPERTENSION

ASTHMA

DIABETES

CHD

HYPOTHYROIDIS

M

STROKE / TIA

COPD

MENTAL H

EALTH

EPILEPSY

CANCERLV

D

Pre

vale

nce PCT A

Kent & Medway

England

Source: QMAS via HSCIC, June 2005

Kent & Medway HIS

PCT AKent &

MedwayEngland

PCT Ranking

K&M Ranking

England Ranking

QMAS Order

HYPERTENSION 11.6% 11.4% 11.3% 1 1 1 4ASTHMA 5.5% 5.3% 5.8% 2 2 2 11DIABETES 3.1% 3.3% 3.3% 3 3 4 5CHD 3.1% 3.2% 3.6% 4 4 3 1HYPOTHYROIDISM 2.3% 2.3% 2.2% 5 5 5 8STROKE / TIA 1.3% 1.4% 1.5% 6 6 6 3COPD 1.2% 1.2% 1.4% 7 7 7 6MENTAL HEALTH 0.7% 0.5% 0.6% 8 9 9 10EPILEPSY 0.5% 0.6% 0.6% 9 8 8 7CANCER 0.5% 0.5% 0.5% 10 10 10 9LVD 0.3% 0.3% 0.4% 11 11 11 2

PCT A

Disease Prevalence at Practice Level

• Comparison of prevalence between Practices for each individual condition

• Basic analysis of the relationship between practice deprivation and disease prevalence for each individual condition

CHD Prevalence by Practice in Ashford PCT June 2005

0

0.02

0.04

0.06

G82053-THE SURGERY G82049-HOLLINGTON

SURGERY

G82658-THE SURGERY G82080-THE

WILLESBOROUGH

HEALTH CNTR

G82186-THE SURGERY G82087-NEW

HAYESBANK SURGERY

G82114-IVY COURT G82094-THE CHARING

SURGERY

G82050-SYDENHAM

HOUSE

G82748-MUSGROVE

PARK MEDICAL

CENTRE

G82142-THE SURGERY G82688-SINGLETON

SURGERY

G82788-NORTH

STREET SURGERY

G82730-KINGSNORTH

MEDICAL PRACTICE

G82712-SINGLETON

MEDICAL CENTRE

G82735-ST STEPHENS

HEALTH CENTRE

Pre

vale

nce

Practice Prevalence PCT Rate (%) K&M Rate (%) England Rate (%)

Source: QMAS via HSCIC, June 2005

CHD - GP Practice Prevalence compared to Practice Deprivation Score

0

0.01

0.02

0.03

0.04

0.05

0.06

0.07

0.08

0 5 10 15 20 25 30 35

IMD 2004 Practice Deprivation Score

Pra

cti

ce

Dis

ea

se

Pre

va

len

ce

Sources: QMAS via HSCIC, June 2005Index of Multiple Deprivation 2004

Kent & Medway HIS

Kent & Medway HIS

CHD Prevalence by Practice in PCT A June 2005

0.0%

2.0%

4.0%

6.0%

a b c d e f g h i j k l m n o p

GP Practice

Pre

va

len

ce

Practice Prevalence PCT Rate (%) K&M Rate (%) England Rate (%)

Source: QMAS via HSCIC, June 2005

GP Practice deprivation scores are weighted estimates based on the National Index of Multiple Deprivation Scores for Kent LLSOAs published in 2004.  

•The registered population for each Practice is broken down by postcode.

•Each postcode is assigned a deprivation score (the score for the LLSOA in which the postcode is located).

•The deprivation score for the postcode is multiplied by the no. of persons registered with the practice that live within that postcode.

•This calculation is repeated for all postcodes for that practice.

•These figures are then summed to give a total for that practice.

•This total figure is then divided by the total registered population of the practice to give an overall weighted deprivation score.

 

Methodology for calculating GP Practice Deprivation Scores:

Kent & Medway HIS

Kent & Medway HIS

CHD - GP Practice Prevalence compared to Practice Deprivation Score

0

0.01

0.02

0.03

0.04

0.05

0.06

0.07

0.08

0 5 10 15 20 25 30 35

IMD 2004 Practice Deprivation Score

Pra

ctic

e D

isea

se P

reva

len

ce

Sources: QMAS via HSCIC, June 2005Index of Multiple Deprivation 2004

Evaluation of the QMAS data

• Issues regarding data capture and disease register inclusion criteria

• Data limitations:– Comparison to other sources of national

prevalence rates

– Local effects National Prevalence Rates

Condition QMAS Other Sources

Males 7.4% CHD 3.6% Females 4.5%

LVD 0.4% 2% in people aged over 45

Males 0.3% Stroke 1.5% Females 0.2%

TIA 1.5 0.3%

4.2% males Hypertension 11.3% 4.9% females

Diabetes 3.3% 4.4%

COPD 1.4% 1.5%

Epilepsy 0.6% 0.5 - 0.1%

Hypothyroidism 2.2% 1.0 - 2.0%

Males 0.46 Cancer 0.5% Females 0.44

Mental Health 0.6% No comparative data

available Males 3.5% Asthma 5.8%

Females 4.6%

Kent & Medway HIS

Sources

Kent & Medway HIS

Condition QMAS Other SourcesMales 7.4% Females 4.5%

LVD 0.4% 2% in people aged over 45Males 0.3%Females 0.2%

TIA 1.5 0.3%22.6% males16.5% females

Diabetes 3.3% 4.4%COPD 1.4% 1.5%

Epilepsy 0.6% 0.5 - 0.1%Hypothyroidism 2.2% 1.0 - 2.0%

Males 0.46Females 0.44

Mental Health 0.6% No comparative data available

Asthma 5.8% 7.5%

Hypertension 11.3%

Cancer 0.5%

National Prevalence Rates

CHD 3.6%

Stroke 1.5%

Sources:

CHD - Health Survey for England, 2003

LVD - Heart of England Screening Study 2001: Davies MK, Hobbs FDR, Davis RC, Kenkre JE, Roalfe AK, Hare R, Wosornu D, Lancashire RJ (2001) Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. The Lancet 358:439-444.

Stroke / TIA - Health Survey for England, 2003

Hypertension - Health Survey for England, 2003

Diabetes - Yorkshire Public Health Observatory PBS Diabetes Prevalence Model 2005

COPD - Lung Report III, British Lung Foundation Report 2000

Epilepsy - The National Society for Epilepysy : J.W. Sander, The incidence and prevalence of epilepsy, 2003

Hypothyroidism - Vanderpump MP, Tunbridge WM.Epidemiology and prevention of clinical and subclinical hypothyroidism.Thyroid. 2002 Oct;12(10):839-47.

Cancer - ONS National Cancer Intelligence Database, 2002

Asthma – Asthma UK / National Asthma Campaign

Kent & Medway HIS

What else has been done?

• Birmingham and Black Country SHA

• North Tees PCT

• Our future plans

Kent & Medway HIS

Kent & Medway HIS

Any Questions?