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We will now
consider the sort of information that you might want to collect
in order to provide a context and background on the area that
the palliative care service operates in. Socio-economic data,
epidemiological data, and data about social structures and cultural
groups are all important. As you can see there is also information
about the future trends - which you will need in order to plan
services.
Example:
Information on London Region, UK
London Region
includes the largest city in the UK with the population of inner
and outer London at almost 7 million in 1997, or 14% of the population
of England. There are areas of high deprivation and poorer health
status (approximately 2 million people), as well as areas of relative
affluence (approximately 2.3 million people). In the 1991 census,
80% of the population classified themselves as white, 8% Black,
10% Asian and 2% other. At a borough level the proportion of people
from black or minority ethnic groups ranges from 4-45%. Over the
next 10 years the white population of London is expected to decrease,
and all other ethnic groups will increase.
There are
16 health districts within the boundaries of the London Region,
formed in 1998, with populations ranging from 249,437 to 737,066.
The health of the population of London is broadly similar to the
rest of England, although it is substantially worse for people
aged under 65 years: the all cause standardized mortality ratio
for 1989-94 was 96, that for those aged under 65 was 104. Spending
on all National Health Services in 1994/5 was $5.2 billion (compared
with $21.8 billion for the rest of England).
The 16 districts
in the London Region can be grouped into socio-economic sectors.
It is sometimes useful to group districts in this way, because
the types of services that are suitable can be affected by deprivation.
For example, in deprived areas fewer cancer patients die at home,
irrespective of age, gender, and diagnosis (Higginson
et al., 1999). London contains some of the most deprived
areas in the United Kingdom. There are four such districts all
in the central zones. There are five districts of mixed socio-economic
status, with the remaining districts all more affluent. Click
here
to view a table providing more detailed information about the
districts of the region.
Question
15.2
The
stern funder of your service says that he thinks that not many
people in the area need palliative care. How would you go about
quickly gathering some information about this? (Click on each
option to see our opinion.)
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