2.5 Population denominators, service provision and usage

This learning object considers the types of data which are required for GIS to support health care management and planning. This object demonstrates the range of data which may be encountered and some of the general principles which will apply. The data required for health care management GIS will often be a mixture of health-specific and external data sources.

We can divide the data required for management of the health care system into three broad categories: firstly, those that relate to the population being served. This information includes not only population numbers but details of demographic, social and cultural characteristics and geographical location. An important aspect of this background information is any knowledge about disease prevalence in the population, although it is important to understand the distinction between prevalence and utilization (discussed below). This information may be used to develop models of the need for health care at many levels of sophsitication, from the simplest location-allocation tasks which aim to provide one health centre or rural health worker for a specified size of population to the most sophisticated hospital bed provision planning, which takes account of the size and location of predicted population demand for services in each medical speciality, utilizing prevalence rates, current population characteristics and predicted changes.

Secondly, management requires information about the organization of the health care system itself. This includes the locations and characteristics of facilities such as health centres and hospitals, but also less directly measurable spatial characteristics such as their effective catchment areas, the transportation options for accessing care and the cost, attractiveness and acceptability of the services themselves. There will also be aspects of the health care system itself, such as the way in which referrals from primary to secondary care are handled, which will affect patients’ interaction with the system.

Thirdly, it is necessary to understand patterns of usage or utilization. This refers to the ways in which different population groups actually make use of the services provided. It is well-established that there are many respects in which usage is not a simple measure of need, in terms of ill health. For example, more use will generally be made of health care facilities by those who can afford them, who are closer to them or who in other ways have the easiest access to them.

Statistics Commission (2004) takes a very broad view of the sources and uses of statistics relating to the UK health care system. Although the specifics of the datasets are unique to the UK, the report provides an extremely useful overview of the reasons why it is so important to have good data about all aspects of a health care system.
 

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