Hull Public Health 

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Chronic Obstructive Pulmonary Disease (COPD)


Documents

The main documents providing information on Chronic Obstructive Pulmonary Disease (COPD) are as follows:

JSNA
Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease Equity Audit completed December 2010

Other documents which include information on COPD or respiratory disease, mainly mortality, are as follows:

JSNA Hull Atlas
Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here)
Public Health Outcomes Framework Summary

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Background

Chronic Obstructive Pulmonary Disease (COPD) is the general name for a collection of diseases which affect the lungs, including chronic bronchitis, emphysema and chronic obstructive airways disease. This corresponds broadly to the codes used to define COPD for the general practice registers as well as the International Classification of Diseases Version 10 (ICD 10) codes and mortality information provided by the NHS Information Centre Indicator Portal. Unless otherwise stated the local reports (JSNA and COPD equity audit) examines bronchitis, emphysema and other chronic obstructive pulmonary disease combined.

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Expenditure and Programme Budgeting

Expenditure and Programme Budgeting is given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease for COPD.

Programme Budgeting is a well-established technique for assessing investment in health programmes rather than services. It can provide an overall view of how Hull PCT expenditure (from Department of Health Programme Budgeting information) and health outcomes compare with other PCT's in England, and to identify programmes that may require further investigation. Quadrant charts are given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease which plot expenditure and outcomes (in standardised units) for different disease areas.

There are also specific programme budgeting and marginal analysis reports for COPD which examines expenditure in relation to outcomes for Hull and compares these with other comparator areas:

PBMA COPD 2009/10
PBMA COPD 2008/09
PBMA COPD 2007/08

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Health Equity Audit

The Chronic Obstructive Pulmonary Disease Equity Audit was completed December 2010. This document includes information on risk factors, inpatient admissions and mortality for COPD. This information was examined in relation to age, gender and deprivation to assess potential inequalities that might exist among these groups. The document also examined potential programmes that could reduce health inequalities.

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Influenza Vaccination

As well as offering influenza vaccinations for those aged 65 and over, it is also recommended that influenza vaccinations are offered for particular 'at risk' groups such as patients on the QOF disease registers for diabetes mellitus, CHD, stroke and chronic obstructive pulmonary disease. Uptake rates for the influenza vaccination for these 'at risk' groups for Hull are given within Hull JSNA Toolkit: Diabetes, Hull JSNA Toolkit: Coronary Heart Disease, Hull JSNA Toolkit: Stroke,and Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

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Inpatient Admissions

The number of inpatient admissions and admission rate are given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Diseaseas well as the admission rates by ward and by general practice. Admission rates are also examined in relation to deprivation.

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Mortality

Mortality rates and mortality rates by deprivation are given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

The mortality rates are also displayed within the JSNA Hull Atlas.

Premature mortality rates for 2006-08 were also examined for the four of the five national deprivation quintiles (not examined for least deprived quintile as so numbers in least deprived quintile too small for Hull) for Hull in relation to other comparable areas. This data is not readily available and analysis was completed with the assistance of the Yorkshire and Humber Public Health Observatory, who hold a copy of the national mortality file and have commissioned the Office for National Statistics (ONS) to produce the LLSOA population estimates. The summary of this analysis is given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

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Prevalence

As part of the Quality and Outcomes Framework (QOF), practices need to have registers of patients who have had a diagnosis of that specific disease. More information about QOF is given in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Diseaseand Glossary. The QOF general practice disease registers cover a range of medical conditions and diseases including COPD, and the prevalence of the disease is reported within Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease. These are also presented by deprivation.

Some of the issues associated with comparing prevalence figures over all the Hull practices are discussed within the General Practice Comparator Groupings, Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease and Glossary, with more detailed information within the Why QOF Differs Among Practices report. Details of grouping practices into eight groups for benchmarking are given in the General Practice Comparator Groupings.

This actual diagnosed prevalence is compared with modelled prevalence estimates. These modelled estimates and the difference between the modelled estimates and the numbers diagnosed at practice level are given within Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease. A modelled or synthetic estimate is only as good as the model and as good as the underlying data from which the model is produced. A full discussion of the Problem of Synthetic Estimates is available, and it is also discussed within Hull JSNA Toolkit: Chronic Obstructive Pulmonary Diseaseand Glossary.

The Projecting Older People Population Information (POPPI) System provides population projections for people aged 65+ years for 2011, 2015, 2020, 2025 and 2030. It provides estimates of the number of people aged 65+ years in Hull are predicted to have bronchitis and emphysema. These estimates are available in Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease and Hull JSNA Toolkit: Older People.

The prevalence of behavioural and lifestyle risk factors is summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Alcohol Consumption, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise and Hull JSNA Toolkit: Overweight and Obesity, with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

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Risk Factors

Risk factors for COPD are discussed within the Chronic Obstructive Pulmonary Disease Equity Audit and JSNA Toolkit. The relationship between smoking prevalence and COPD is also examined in more detail, as well as estimating the number of deaths from COPD attributable to smoking.

The prevalence of behavioural and lifestyle risk factors is summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Alcohol Consumption, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise and Hull JSNA Toolkit: Overweight and Obesity, with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

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Smoking

Mortality rates from COPD are compared with smoking prevalence by local deprivation quintiles within Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease, while Hull JSNA Toolkit: Smoking provides an estimate of the numbers of deaths from COPD attributable to smoking.

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Social Marketing

Social marketing work has been undertaken in relation to smoking and chronic obstructive pulmonary disease. An important finding with regard to smoking was that there was a perceived health danger relating to quitting smoking "quit and you'll die". Details are given within the smoking section of Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

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