Abstract

Health systems around the world are struggling to cope with increasing healthcare costs and rising demand due to an ageing population. There have been several financial initiatives in the NHS to motivate improved performance.

The aim of this study is to examine the link between healthcare expenditure in both primary and secondary care and health outcomes and whether this relationship varies with levels of deprivation.

The study is done in Dorset PCT, which has one of the highest proportion of over 75 year olds in England. The dataset in the study is based on routinely collected data from financial, programme budgeting as well health datasets (incidence, mortality, morbidity, and hospital activity data). We examined the relationship between the various financial initiatives like Payment by Results for secondary care, and Quality and Outcomes framework for primary care and associated disease specific outcomes within each programme category.

For each deprivation quartile, activity, cost and outcome indicator distributions will be examined using box-plots and any differences evaluated for significance. Effects of covariates on years of life lost will be assessed with a 2-step model and a generalised linear model. Using a years of life lost as a measure of health outcomes, the expenditure required to save a year of life for different age groups will be estimated.

The results from this study will be used to help improve decision making at the local level, which is particularly important in the current economic climate.

Results will be presented at the conference.