Sociodemographic and morbidity indicators of need in relation to the use of community health services: observational study

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Abstract
Objective: To examine whether the sociodemographic and morbidity characteristics of populations influence their use of the following community health services: district nursing, health visiting, chiropody, community maternity, community mental illness, and the professions allied to medicine. Design: Observational study. Setting: Nationally representative sample of provider trusts in England. Main outcome measures: Activity levels for each service calculated for enumeration districts within the catchment areas of the sample of trusts and standardised to allow for differences in age structure. Regression analysis to determine whether the standardised activity rates for each service could be predicted by a range of socio-demographic and morbidity proxies. Results: Morbidity or deprivation, or both, seemed to influence the use of services in each of the care programmes examined. Conclusions: The allocation of funds for community health services should allow for differences in the health and socio-demographic characteristics of health authorities. Previous work to determine an appropriate target allocation of funds for health authorities has concentrated on inpatient services The portion of health expenditure estimated to be necessary for community health services has been given a zero weighting by the Department of Health This decision has attracted considerable criticism This study shows that deprivation and other demographic characteristics influence the use of community health services These findings have been used to help inform the target allocation of funds to health authorities

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