Routine Data SDL

Question 1

What are the 2 sources of data that are used by practitioners and researchers to understand the world around them?

Answer 1

• raw data collected expressly in the pursuit of knowledge through direct observation
• routinely collected data

Question 2

What is routinely collected data?

Answer 2

• data collected routinely by organisations as part of
  their day-to-day activities
• usually captured for the purpose of oversight by government or a statutory body who is obliged to collect information so that they can be accountable to their stakeholders

Question 3

What is meant by a ‘data set’?

Answer 3

• a list of fields, population with data of a pre-agreed format
• this set is applied across all the places from where data are collected

Question 4

Give examples of when routine data collected for financial reasons

Answer 4

• NHS admission recorded so that costs can be attributed to the CCG
• decennial census, allows planning of public services

Question 5

Describe the advantages and disadvantages of the two types of data

Answer 5

• capturing primary data is expensive, slow and time consuming. But data collected is tailored and you have control over its quality.
• routinely collected data not tailored to your area of interest, the data may have usage restrictions to protect confidentiality, may be captured by people who may not be qualified, or indeed motivated,
• routine data has little or no cost, quick and cheap, can set out with a clear hypothesis to test the conventional empirical fusion, but also you can explore the data in ways that are hypothesis generating

Question 6

What is meant by the spatial dimension?

Answer 6

• research should be clear about the population to which it refers
• very often we define our study population as the population of a particular area

Question 7

Give an example of when geography will be important to explore a non-geographical variable

Answer 7

e. g. the socioeconomic status of a research subject
- rather then asking them how ell off they are, you could infer this from the characteristics of the neighbourhood where they live

Question 8

What is meant by geographical units?

Answer 8

postcodes, counties, constituencies

- must be well understood by anyone working with routinely collected data

Question 9

What information can be gather from the census?

Answer 9

• running since 1841, every 10 years
• level of the individual and household
• can see data on population structure/density, ethnicity, religion, housing, commuting habits, migration, changes over time

Question 10

What is the smallest geographical area for which data are available?

Answer 10

census output area

Question 11

What is a super output area?

Answer 11

• designed to improve reporting of small group areas statistics
• built from groups of OAs

Question 12

What are structural levels of the NHS in England?

Answer 12

• NHS commissioning regions x4
• NHS area teams x25
• Clinical commissioning groups

Question 13

What are the structural levels of the NHS in Scotland?

Answer 13

• scottish government
• health boards
• community health partnerships

Question 14

What are the structural levels of the NHS in Wales?

Answer 14

• NHSWD regional offices

- local health boards

Question 15

What are the structural levels of the NHS in Northern Ireland?

Answer 15

• single health and social care board

- local commissioning groups x5

Question 16

Where can the list of NHS organisation codes be found?

Answer 16

Organisation Codes Service of the NHS Information Centre

Question 17

What type of data stets are routinely collected by the NHS?

Answer 17

• community
• maternity/childrens
• commissioning
• diagnostic imaging
• mental health services
• psychological therapies
• renal
• speciality list
• workforce
• NHS health direct
• emergancy care

Question 18

Why are postcodes useful in healthcare geography?

Answer 18

• every postcode has a small geographical area associate with it, with a definable central point
• can locate address and find out its electoral ward, a Local Authority or a CCG
• can be used to map water borne infectious outbreaks or airborne exposure paths of pollution clouds

Question 19

Why is routine data used in standardising calculations?

Answer 19

• Standardising is done to adjust for the effect of age and sex of the population on incidence, prevalence, mortality, probability of cure etc.
• Need to know the size of the at risk population in order to do this

Question 20

Describe the two ways people can be allocated to groups based on their socioeconomic status

Answer 20

1. ask them a set of questions designed to find out what their circumstances are
2. estimate them based on where they live

Question 21

What are the advantages of estimating socioeconomic stats based on where someone lives?

Answer 21

• neighbourhoods in the UK tend to be quite homogeneous, particularly if you use geography such as lower level super output areas
• if you can capture someone’s postcode of residence you can attribute them to almost any geography you like

Question 22

What are the 5 scores used to estimate socioeconomic status?

Answer 22

• Townsend Score
• Carstairs Score
• Jarman Score
• Indexes of Multiple Deprivation
• Socio-economic Status at the Level of the Individual

Question 23

What four variables comprise the Townsend score?

Answer 23

• unemployment
• non car ownership
• non home ownership
• household overcrowding
  The greater the score the greater the degree of deprivation

Question 24

What are the advantages and disadvantages of the Townsend score?

Answer 24

Advantages
- widely accepted, simple to understand, widely used
Disadvantages
- uses census data so can be out of date
- measures deprivation not affluence, so only measures the number of deprived people living in an area, even if overall there are more affluent people
e.g. a middle class population with have a lower score than an affluent area with some converted flats

Question 25

What four variables comprise the Carstairs Score?

Answer 25

- low social class - lack of car ownership - overcrowding - male unemployment

Question 26

What eight variables are used to calculate the Jarman Score?

Answer 26

- % of elderly living alone - % children under 5 - % unskilled workers - % overcrowded households - % changed address in last year - % residents living in a household where in head was born in the New Commonwealth or Pakistan - % unemployed - % households containing lone parents

Question 27

What are the advantages and disadvantages of the Jarman Score?

Answer 27

Advantages - can be used for small area, diverse range of measurements make up the score Disadvantages - different within wards are often masked as there can be great variation of deportation within a particular ward, the data is 10 years out of date, it doesn't indicate the proportion of people in an area that are deprived, it is biased towards the urban population

Question 28

What seven domains comprise the English Indices of Deprivation?

Answer 28

- income deprivation - employment deprivation - health deprivation and disability - education, skills and training deprivation - barriers to housing and services - crime deprivation - living environmental deprivation

Question 29

Describe the use of Indexes of Multiple Deprivation

Answer 29

- governments have used these for some time - profiling communities in order to plan local service - used in Local Government - weighting of various measures of environment, unemployment, crime, education and other factors to arrive at a composite score - use of Lower Level Super Output Area

Question 30

How can socioeconomic status at the level of the individual be assessed?

Answer 30

- classify people according to occupation | - used as a proxy for educational attainment and income

Question 31

How are occupations classified for the census?

Answer 31

1. higher managerial, admonition and professional occupations 2. lower managerial, administrative and professional occupations 3. intermediate occupations 4. small employers and own account workers 5. lower supervisor and technical occupations 6. semi-routine occupations 7. routine occupations 8. never worked and long-term unemployment

Question 32

Define what the ICD-10 code is | What, other than death is the ICD-10 code used to classify?

Answer 32

- a medical classification list by WHO which contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease - it is used by physicians, nurses, researchers, health information mangers, policy makers, insurers and patients organisations to classify diseases and the health problems recorded on many types of health and vital records including death certificates and health records

Question 33

What is meant by bespoke deaths data and where can it be accessed?

Answer 33

- bespoke data set for smaller area or very precise causes - need to approach someone who holds raw death data - Public Health Observatories handle similar data for regions

Question 34

What are the 2 distinct levels of routine data collected about health?

Answer 34

- patients notes = day-to-day clinical decisions | - primary care vs secondary care very different

Question 35

What is the UK trying to do about the issues of routine data collection on health?

Answer 35

- long term and large scale programme whereby all disparate sources of information on patients will be merged into one source containing elements which are effectively routinely collected data, as well as the richer narrative of the patients pathway through health services

Question 36

What data do Hospital Episode Statistics collect?

Answer 36

common health contact in which a standardised data set in constantly collected across the country - records admissions to hospital

Question 37

What is the basic unit of the hospital episode statistics database?

Answer 37

- 'episode of care' - period o time that patient spends under the care of a consultant - 90% of all admissions consist of just one episode of care, but some patient may be admitted under one specialty for a short amount of time and then transferred (especially emergency cases)

Question 38

How is data in the following areas collected?: 1. Primary Care 2. A&E 3. Pathology 4. Public Heath England 5. Ambulance Services 6. Cancer

Answer 38

1. Primary Care - Clinical Practice Research Datalink 2. A&E - crude A&E minimum data set, but not routinely available to community - individual hospitals/CCGs hold raw data 3. Pathology - individual hospital hold pathology results, rarely used for large scale studies 4. Public Heath England - regular analyses of interest to researchers and students e.g. infectious disease 5. Ambulance Services - minimum data sets for crew to complete - some quality problems - rarely used in research 6. Cancer - Cancer registries collect every cases person, disease, treatment and outcome - related to individuals so strict usage - National Cancer Registration and Analysis Services (NCRAS)

Question 39

Give 2 examples of sampled studies of population and life course studies

Answer 39

1 . Health Survey for England - large scale population survey expiring health and health determinants - some self-reporting questions, others clinical measurements - sometimes has a running theme e.g cardiovascular health - run by the Economic and Social Data Service at the University of Essex 2. British Household Panel Survey - annual survey, stratified sample of British households longitudinally - includes things like income, employment, education, use of health services - run by the Economic and Social Data Service at the University of Essex

Question 40

What is meant by lifecourse studies?

Answer 40

- large cohorts of people followed over long period of time - gives insight into population incidence and prevalence of disaeseas, data on lifestyle factors, trends in mortality - Institute of Education has Lifecourse Studies Centre