An article examined patient mortality in hospitals running the Advancing Quality programme, a pay-for-performance programme introduced in all hospitals in the north west region of England in 2008. An earlier article had reported a reduction in mortality in the first 18 months of operation, and this article now examined the longer term trends. It said that, while the quality of care continued to increase over the following two years, there had been no further reduction in patient deaths in the region covered by the programme over that observed in the rest of England.
Source: Soren Rud Kristensen, Rachel Meacock, Alex Turner, Ruth Boaden, Ruth McDonald, Martin Roland, and Matthew Sutton, 'Long-term effect of hospital pay for performance on mortality in England', New England Journal of Medicine, Volume 371 Number 6
A new book examined key social and ethical dilemmas facing ageing societies (such as autonomy, agency, frailty, social isolation, and dementia), bringing together two streams of thought within critical gerontology: analyses of structural issues in the context of political economy; and humanistic perspectives on issues of existential meaning.
Source: Jan Baars, Joseph Dohmen, Amanda Grenier, and Chris Phillipson, Ageing, Meaning and Social Structure: Connecting critical and humanistic gerontology, Policy Press
A report examined mortality measurement as an indicator of healthcare quality.
Source: Roger Taylor and Paul Aylin, Mortality Measurement: The case in favour, Dr Foster
A paper examined the issue of missing data in the English Patient-Reported Outcome Measures survey, and proposed a strategy for addressing this, using multiple imputation techniques. The paper also discussed its impact on assessing provider performance.
Source: Manuel Gomes, Nils Gutacker, Chris Bojke, and Andrew Street, Addressing Missing Data in Patient-Reported Outcome Measures (PROMs): Implications for comparing provider performance, Centre for Health Economics (University of York)
An article examined trends in place and causes of death for centenarians in England, drawing on death registration data linked with area-level indices of multiple deprivations for people aged 100 years or over who died between 2001 and 2010 in England, compared with those dying at ages 80-99. It said that centenarians were more likely to die as a result of acute conditions such as pneumonia and conditions related to frailty, and less likely to have causes of death of cancer or ischemic heart disease, compared with younger elderly patients. Most were found to have died in a care home (nursing or residential), but 27 per cent died in hospital. It noted implications for policy on residential and anticipatory care for the oldest old.
Source: Catherine Evans, Yuen Ho, Barbara Daveson, Sue Hall, Irene Higginson, and Wei Gao, 'Place and cause of death in centenarians: a population-based observational study in England, 2001 to 2010', PLoS Medicine, Volume 11 Number 6
A paper examined alcohol-related deaths in Glasgow. It said that Glasgow's poor health was compounded by high levels of deprivation in the city and, since the 1980s, alcohol-related deaths in the most deprived areas had risen more than those in the least deprived areas. In the city as a whole, alcohol-related deaths had decreased slightly in the early 2000s, which the paper attributed to the impact of the economic downturn and restrictions on alcohol multiple-buy offers, but there had been a disproportionate increase in alcohol-related deaths in young working-age females, and there were still significant differences in alcohol-related mortality across the 21 wards in the city.
Source: Alcohol-related Harm in Glasgow: A national, city and neighbourhood perspective, Glasgow Centre for Population Health
A report examined the incidence and consequences of neurological disease in England. It said that there was a need to improve the data and intelligence on neurological conditions and outlined a roadmap for improving and deploying such data, with short, medium, and long-term goals for government, NHS England, Public Health England, and the Health and Social Care Information Centre.
Source: Measuring Up: Improving the collection of neurological data and intelligence, Neurological Alliance
An article examined how life expectancy had changed in Europe between 1991 and 2008, looking at geographical inequalities (between regions) and socio-spatial inequalities (between regions grouped by an area-level measure of average household income). It was found that regional life expectancy inequalities had not narrowed, despite efforts to reduce them. It said that household income differences across European regions might partly explain these inequalities but, because inequalities transcended national borders, reduction efforts might require European Union-wide co-ordination in addition to national efforts.
Source: Elizabeth Richardson, Jamie Pearce, Richard Mitchell, Niamh Shortt, and Helena Tunstall, 'Have regional inequalities in life expectancy widened within the European Union between 1991 and 2008?', European Journal of Public Health, Volume 24 Issue 3
A report examined child mortality in the United Kingdom. It said that infant, child, and adolescent death rates had declined substantially and continued to fall, but there remained areas of concern. Key points included: that the UK had a higher overall childhood mortality rate than in some other European countries; that intentional injury deaths among young people had not been reduced; and that there were marked social inequalities in death rates. The report said that many of the causes and determinants of childhood deaths were preventable, and discussed ways in which to address ongoing concerns. A second report, published alongside, outlined recommendations for reform in England.
Source: Ingrid Wolfe, Alison Macfarlane, Angela Donkin, Michael Marmot, and Russell Viner, Why Children Die: Death in infants, children and young people in the UK – Part A, Royal College of Paediatrics and Child Health/National Children's Bureau/British Association for Child and Adolescent Public Health
Source: Why Children Die: Death in infants, children and young people in the UK – Part B, Royal College of Paediatrics and Child Health/National Children's Bureau
A report presented experimental statistics on deaths that were considered avoidable in the presence of timely and effective healthcare or public health interventions (avoidable mortality). Key points included that: avoidable deaths accounted for approximately 23 per cent of all deaths registered in England and Wales in 2012; the leading causes were ischaemic heart disease in males and lung cancer in females; and rates of avoidable deaths were significantly higher in Wales than in England throughout the period 2001-12, but varied across the regions of England. The report advised some caution in interpreting the data, in view of a number of limitations.
Source: Avoidable Mortality in England and Wales, 2012, Office for National Statistics
A report examined the prevalence of mental health conditions and intellectual disability in the United Kingdom, their relationship with physical health, and the actions needed to reduce disparities in morbidity and mortality among the group of people with such conditions, compared with the rest of the population. It called for a range of changes, including: a national mortality review system; better prevention and early intervention strategies for mental health; enhanced training and workforce planning to improve the quality of care; more joined-up care, particularly through improving commissioning and delivery processes; and greater research focus on mental-physical multi-morbidity.
Source: Recognising the Importance of Physical Health in Mental Health and Intellectual Disability: Achieving parity of outcomes, British Medical Association
A report provided an overview (described as a 'resource document') of how the national health and care system in England would work towards reducing premature avoidable mortality.
Source: Living Well for Longer: National support for local action to reduce premature avoidable mortality, Department of Health
A report examined the challenges in caring for increasing numbers of frail older people in the United Kingdom. It made recommendations for change, including: improvements to information sharing; wider use of technology, such as telemedicine; annual frailty checks for people over the age of 75, along with priority access and rapid assessment schemes; personal or per capita budgeting to fund home repairs, adaptations, and homecare support; and changes in responsibilities, alongside new commissioning/funding models, for health and social care providers.
Source: Better Care for Frail Older People: Working differently to improve care, Deloitte Centre for Health Solutions, Deloitte LLP
A report examined, at a strategic level, the purpose and structure of residential care services in Scotland, with a view to meeting the aspirations and needs of future generations. It said that expansion would be required in extra care, rehabilitation/prevention, and high dependency care. Future services would need to take account of the needs and wishes of service users and the report recommended further work on the development of appropriate tenancy models. It also recommended clarification of the definition of housing support, and made observations and recommendations regarding capacity planning, funding, commissioning, and quality assurance.
Source: Task Force for the Future of Residential Care in Scotland, Recommendations for the Future of Residential Care for Older People in Scotland: Summary, Scottish Government
An article said that the gap in heart disease deaths for those aged over 65 in the richest and poorest areas of England had widened since the 1980s, despite general improvements.
Source: Perviz Asaria, Lea Fortunato, Daniela Fecht, Ioanna Tzoulaki, Juan Jose Abellan, Peter Hambly, Kees de Hoogh, Majid Ezzati, and Paul Elliott, 'Trends and inequalities in cardiovascular disease mortality across 7932 English electoral wards, 1982–2006: Bayesian spatial analysis', International Journal of Epidemiology, Volume 41 Number 6
A report examined the use of life expectancy measures in United Kingdom policy, the drivers behind demographic shifts and population ageing, and the means, and use, of life expectancy calculations for policy purposes. It said that life expectancy was a measure of quantity, not quality, of life and that policies such as setting the state pension age needed to take account of healthy life expectancy and disability-free life expectancy. The report said that such measures varied significantly by region and social class, and policy decisions could therefore disadvantage particular groups more than others. It noted that raising the state pension age would transfer spending from the state pension to disability and unemployment benefits. The report made a range of recommendations for policy.
Source: David Sinclair, Kirsten Moore, and Ben Franklin, Linking State Pension Age to Longevity: Tackling the fairness challenge, International Longevity Centre – UK
An article examined the associations between social mobility, income inequality, and socio-economic differences in mortality in European countries. Both income equality and social mobility were found to be associated with larger socio-economic differences in mortality, particularly in women. These findings suggested that although social mobility and income equality might improve population health, they might also increase socio-economic health inequalities.
Source: Audrey Simons, Danielle Groffen, and Hans Bosma, 'Socio-economic inequalities in all-cause mortality in Europe: an exploration of the role of heightened social mobility', European Journal of Public Health, Volume 23 Issue 6