Poverty costs NHS bil­lions, re­port warns

Link be­tween de­pri­va­tion and ill­ness

Yorkshire Post - - NEWS - JOHN ROBERTS ED­U­CA­TION COR­RE­SPON­DENT Email: john.roberts@ypn.co.uk Twit­ter: @york­shire­post

THE COUN­TRY’S health in­equal­ity is cost­ing the NHS in Eng­land in £4.8bn a year, al­most a fifth of the to­tal NHS hos­pi­tal bud­get, ac­cord­ing to new univer­sity re­search.

A team from York Univer­sity has found that the more de­prived the neigh­bour­hood that some­one lives in, the more likely they are to be ill or to re­quire ad­mis­sion to hos­pi­tal.

The au­thors of a new re­port say their find­ings make a fi­nan­cial case for tack­ling the dif­fer­ences in the health of peo­ple from af­flu­ent and de­prived com­mu­ni­ties.

Their re­search found a “so­cial gra­di­ent” in poor health af­fects every­one in the coun­try, and not just those liv­ing in the most de­prived neigh­bour­hoods.

Peo­ple liv­ing in the most de­prived fifth of neigh­bour­hoods have 72 per cent more emer­gency hos­pi­tal ad­mis­sions and 20 per cent more planned ad­mis­sions than peo­ple liv­ing in the most af­flu­ent fifth of neigh­bour­hoods, the study re­veals.

As a re­sult, av­er­age hos­pi­tal costs for the poor­est peo­ple are al­most 50 per cent higher than those for the rich­est, and there is an eight year gap in life ex­pectancy for men and a six-year gap in women be­tween peo­ple liv­ing in the most de­prived and most af­flu­ent neigh­bour­hoods.

Over their life­times, men liv­ing in the most de­prived neigh­bour­hoods cost the NHS 16 per cent more than men liv­ing in the most af­flu­ent neigh­bour­hoods, de­spite hav­ing shorter life ex­pectan­cies.

Women liv­ing in the most de­prived neigh­bour­hoods cost 22 per cent more than women liv­ing in the most af­flu­ent neigh­bour­hoods, the au­thors con­clude.

Miq­dad Asaria, from York Univer­sity’s Cen­tre for Health Eco­nom­ics, said: “At a time when the NHS bud­get is un­der a great deal of pres­sure this study shows that so­cio-eco­nomic in­equal­i­ties in so­ci­ety are ex­act­ing a huge bill on the health ser­vice.

“In ad­di­tion to the strong moral case for tack­ling the un­jus­ti­fi­able dif­fer­ences in health be­tween the rich and the poor there is also a strong fi­nan­cial case for do­ing so.”

The study, pub­lished in the Jour­nal of Epi­demi­ol­ogy and Com­mu­nity Health, used gov­ern­ment data on ev­ery hos­pi­tal ad­mis­sion and death in the coun­try from April 2011 to April 2012.

It shows that re­duc­ing the causes of ex­cess ill­ness as­so­ci­ated with de­pri­va­tion will both ex­tend lives and re­sult in sig­nif­i­cant sav­ings to the NHS. The NHS hos­pi­tal bud­get makes up a fifth of the to­tal NHS bud­get of ap­prox­i­mately £100bn.

If sim­i­lar in­equal­i­ties were to be ob­served in other parts of the NHS, such as pri­mary and spe­cial­ist care, the to­tal cost of in­equal­ity to the NHS would be al­most £20bn, ac­cord­ing the re­port’s au­thors.

The univer­sity has also pro­duced new re­search along with Manchester and Michi­gan uni­ver­si­ties which found that a ma­jor care pay for im­prov­ing pa­tient health care and out­comes has not saved any ad­di­tional lives

In 2004, the Qual­ity and Out­comes Frame­work (QOF) was in­tro­duced across gen­eral prac­tices in the UK. It in­creased GP in­come by up to 25 per cent, de­pen­dent on per­for­mance on over 100 qual­ity of care in­di­ca­tors. In its first seven years, the scheme cost the NHS £5.86bn.

An anal­y­sis of the QOF, shows mod­est re­duc­tions in deaths, but no sta­tis­ti­cally sig­nif­i­cant declines in mor­tal­ity rates for the chronic con­di­tions tar­geted by the pro­gramme, in­clud­ing cancer, di­a­betes and heart dis­ease.

In­equal­i­ties are ex­act­ing a huge bill on the health ser­vice. Miq­dad Asaria, from York Univer­sity’s Cen­tre for Health Eco­nom­ics

MIQ­DAD ASARIA: Strong fi­nan­cial as well as moral case for tack­ling dif­fer­ences in health.

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