Office for National Statistics

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Office for National Statistics Public Health

• Dr Azeem Majeed
• Office for National Statistics University
  College London

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Structure of session

• Structure function of ONS
• Recent developments in government statistics
  analysis
• Small group work on primary care data

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Learning objectives

• ONS - structure function
• Health related data
• Future developments in government statistics
• Opportunities for training collaborative work
• DH review of primary care data

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What is the ONS?

• Formed in 1996 by the merger of Office of
  Population Censuses and Surveys Central
  Statistical Office
• Main arm of the government statistical service
• Responsible for publication of wide range of
  government statistics

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Public health related work

• Health Care
• Population vital statistics

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Health Care

• Mortality
• Morbidity
• Child Health
• Cancer
• Longitudinal survey
• Geographical variations

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Publications

• Health Statistics Quarterly
• Population Trends
• Ad-hoc publications
• Web site (www.statistics.gov.uk)

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Opportunities for training

• ONS approved location for SpR training
• Previous projects include accidents, deaths from
  overdose, atrial fibrillation, epilepsy.
• Development of analytical skills, knowledge of
  routine data sources publication of work
  encouraged
• SpRs from other specialties

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Supporting public health I

• Collection analysis of routine statistics
• Decennial census
• Population estimates
• Deprivation measures
• Birth death rates
• Cancer incidence survival
• Teenage conception rates

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Supporting public health II

• Primary care
• Health inequalities
• Measuring the burden of disease
• Reducing suicide
• New methods of measuring case-mix

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Primary care

• Prevalence of chronic diseases
• Prescribing rates
• Time trends
• Variations
• Regional, socio-economic, practice
• Provide information for planning health services
  for DOH, PCTs etc.

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Relative risks in AF patients
45-64 yrs 65-74 yrs 75 yrs
IHD 4.5 2.6 2.5
Heart failure 33.5 7.5 3.7
Raised BP 2.5 1.4 1.5
Diabetes 1.6 1.4 1.1
Stroke 8.6 3.2 2.9
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Prevalence of IHD use of statins in E W in
1998
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Some other diseases examined

• Heart failure
• Hypertension
• Asthma
• Epilepsy
• Schizophrenia
• Peptic ulceration

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Annual No. of contacts with GPs
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Referral rates per 1,000 (males)
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Referral rates per 1,000 (females)
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Reducing deaths from suicide

• Reducing deaths from overdose an important
  component
• GPs will play an important role
• New database of deaths from overdose developed by
  ONS
• Allows more sophisticated and flexible analyses
  than previously

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Toxicity index for antidepressants
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Measuring case-mix in primary care

• Comparing performance
• Examining use of resources
• Adjusting referral rates
• Case mix measurement based on patients medical
  history
• Budget setting

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Percentage referred in one year
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Burden of disease

• Measuring the burden of disease
• GP consultations
• Prescribing
• Referrals
• Admissions
• Projections

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Hip fracture admissions among over 65 year olds
in England
1998 2022 Increase
Men 11,562 16,410 42
Women 45,984 53,126 12
Total 57,546 69,536 21
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Other areas

• Teenage pregnancy
• Social regional variations
• Health surveys
• Linkage studies
• Child health
• E-Strategy (www.statistics.gov.uk)

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Conclusions

• Work of ONS ONS data important to people
  working in public health
• Learn how to use data to help plan monitor
  health services and the health of the public

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Primary care data

• Department of Health reviewing primary care data
• Workshop in August/September
• Report later this year

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Issues to be considered

• Who are the users of primary care data?
• What data are currently available?
• What are the strengths limitations of these
  data?
• How can primary care data be used?
• How can data from primary care be improved?