Analysis from inner London of deprivation payments based on enumeration districts rather than wards.
To estimate the effect of calculating the Jarman index using the smaller geographical unit of the census enumeration district on the changes in deprivation payments made to general practitioners.
The Jarman index, or underprivileged area score, is used to calculate the allowance that general practices in the United Kingdom receive for each patient registered with them who fives in an area of relative social deprivation.
Current values of the Jarman score are derived from the 1981 census and are based on electoral wards.
The change in payments to some practices brought about by using data from the 1991 census may cause severe financial hardship.
Main outcome measures-Standard deviations of the changes in payments to practices.
Extreme values of changes in payments.
The standard deviation of the change in payment between the two censuses was £6365 with the enumeration district Jarman index, whereas it was £9452 under the ward based scheme.
If the ward based scheme is used 10 practices would find their payments changed by over £20 000, whereas only two practices would have changed by more than this amount under the scheme based on enumeration districts.
Conclusion-The Jarman index could be more sensitively and appropriately applied to calculate the deprivation payments that practices receive using the census enumeration district as its unit for calculation.
This would result in fewer precipitate changes in payments when census data change every 10 years.
Mots-clés Pascal : Economie santé, Homme, Paiement, Privation, Angleterre, Grande Bretagne, Royaume Uni, Europe
Mots-clés Pascal anglais : Health economy, Human, Payment, Deprivation, England, Great Britain, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0548101
Code Inist : 002B30A01B. Création : 01/03/1996.