« Previous | Contents | Next »
Listen
REPORT OF THE WORKING GROUP ON MONITORING SCOTTISH DIETARY TARGETS
Appendix 4: Sources of Data on Health Outcomes
A.4.1 There are several sources of data on the health outcomes that were given in Sections 2.4.1 and 2.4.2 of the Working Group report and these are outlined in the following paragraphs.
A.4.2 Two sources of data on health outcomes are Continuous Morbidity Recording (CMR) and Practice Team Information (PTI). CMR covers seventy General Practitioner (GP) practices in Scotland. Every time a patient consults their GP in one of these practices the reason for the visit will be recorded, and then coded (up to ten reasons can be recorded). It is thus possible to see how many people are presenting with cancer or coronary heart disease for example. The PTI records interventions and reason for contact if the patient sees a Practice Nurse, District Nurse or Health Visitor but not a GP.
A.4.3 Neither the CMR nor the PTI records data on cholesterol, body mass index (BMI), height or weight, but the PTI is designed to record activity, along with associated morbidity, and so records if such readings were taken. The CMR data is only representative at national level and cannot be broken down to a regional level (as it is in the SHS). PTI data from April 2003 onwards is only representative at national level and cannot be broken down at regional level. In the case of the CMR, recording is limited by the codes available and also by the fact that most people will not present at their GP complaining of obesity, it is more likely to be recorded as a side note, if at all.
A.4.4 The Information and Statistics Division (ISD), on behalf of the National Health Service (NHS) host the Scottish Cancer Registry. Data on the incidence and prevalence of various cancers can be accessed from the ISD website:
www.isdscotland.org
A.4.5 Each Health Board in Scotland maintains a diabetes register. These vary in quality and coverage but could be used to provide an indication of the incidence and prevalence of NIDDM in Scotland.
A.4.6 The Management Information Dental Accounting System (MIDAS), is the General Dental Service payments system, from which information on patients, treatments, practitioners and payments can be derived. The drawback of this system is that some core child treatments must be provided as part of the capitation fee and so they are not recorded. Thus, there is no way of determining whether or not these treatments have taken place without accessing the patient's record card or looking in their mouth.
A.4.7 The Scottish Health Boards Dental Epidemiology Programme (SHBDEP) is a source of trend data on decayed, missing and filled teeth in children. The teeth of children aged 5 and 12 are examined throughout Scotland on a rolling programme and the data is analysed by the Dental Health Services Research Unit at the University of Dundee. Results are fed back to Health Boards and published. It is possible to analyse some of the data by deprivation category.
A.4.8 The IDS(S)37 is the new Community Dental Service scheme and will record information on dental health education and promotion, formal, evaluated dental health programmes and the national dental inspection programmes. This latter part will hold high-level data and it is likely that the information will categorise children's needs for dental intervention into three groups: number with zero caries, number requiring dental referral and number requiring treatment for caries. However this has still to be agreed with the service.
A.4.9 As part of the Child Health Surveillance System in Scotland, anthropometric data on children (height or length, weight, head circumference) is routinely collected at a number of stages during childhood (mainly pre-school years). This allows longitudinal follow up of children's growth and, potentially, their nutritional status. These national data sets are managed by ISD.
A.4.10 The SHS measures lifestyle choices (e.g. smoking, physical activity), risk factors (e.g. obesity, blood pressure) and various health outcomes (e.g. coronary heart disease, asthma) and due to the methodology used this could be linked to an individual's dietary intake. The SHS can also be used to carry out analysis by deprivation, socio-economic group and other characteristics of the population.
A.4.11 The use of proxy measures of health was considered but was deemed inappropriate. Although people living in poorer areas may use services more often than people living in affluent areas this does not fully reflect their level of need or morbidity, and would underestimate the level of health (or illness) in these groups.
« Previous | Contents | Next »