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

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

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

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

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

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

21/02/02 6 Interpretation of trends

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

21/02/02 8 Clues to causes

21/02/02 9 Clues to causes

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

21/02/ % 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%

21/02/ % 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%

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

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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: