Inequalities in health care service use
Health care service utilisation after a diagnosis of dementia or another neurodegenerative condition – assessing the impact of inequalities
What are we trying to find out?
- What difference does your ethnicity or where you live make to your use of health care services if you have dementia or a neurodegenerative condition in England?
- How much of a difference does socio-economic background, ethnicity and where you live make to the health services you use if you have one of these conditions?
- How much does it cost to provide these health services?
- Are differences in accessing health care services increasing over time?
Why is this important?
Everyone who lives with a neurodegenerative condition will need some support from health care services. However, not everyone gets the same level of support once diagnosed. This is often called the ‘postcode lottery’, referring to the fact that where you live makes a difference to the support available.
Research shows that various things affect service use, including your ethnicity, where you live and your socio-economic background. Most pre-existing evidence is about dementia. Little is known about patterns of service use for people living with other neurodegenerative conditions.
A lot of what is known about service use among people with dementia is based on data collected up until 2016. This did not look at how much services cost. Cost matters because since then the COVID-19 pandemic has put more pressure on the NHS. Local healthcare budgets have not increased. All of this could have increased pre-existing inequalities in accessing services.
How are we going to do it?
- We will review the evidence which has been published on this topic. We will search scientific journals, policy reports and organisational recommendations.
- We will draw on national databases to look at how people with dementia use health care services. We will look at how patterns of use change by geographical region, socio-economic position, and ethnicity. We will calculate the cost of these services using NHS reference costs and national tariff prices.
- We will repeat step 2 for people living with other neurodegenerative conditions. We will look in as much detail as the data will allow.
- We will compare service use 12-, 24- and 60-months post-diagnosis to see whether these patterns of service use change over time and whether inequalities have increased.
Who is involved?
Professor Matthew Prina (Newcastle University) is leading the project alongside colleagues Professor Martin Knapp (LSE), Dr Adelina Comas-Herrera (LSE) and Dr Catherine Quinn (Bradford). Professor Fiona Matthews (Hull) is a collaborator.
Two experts by experience will be part of the project team. They will link us with the broader Involvement Network.
How will we share our findings?
We will
We will agree how to share our findings by consulting with our Involvement Network. We expect our strategy to include:
- A project report
- Plain English summaries with infographics (including maps to highlight regional differences)
- Publishing scientific journal articles
- Presenting our work at conferences and other stakeholder events
- Creating resources which can be incorporated into teaching materials