Illustrating the Concept of Unmet Need Acute MLC

Illustrating the Concept of Unmet Need Acute MLC sub-group: 2 nd October 2014

Outline: • • Description of the issue; Use of spline functions; Other methods; Questions.

All need manifests in utilisation Utilisation x x x x x x x x x x x x x x Indicators of need

Deviation from full utilisation Utilisation x x x x x x x x x x x x x x Indicators of need

Utilisation Unmet need x x x x x x x x x x x x x x Indicators of need

Testing for unmet need – spline functions Utilisation Lower cut-off Upper cut-off x x x x x x x x x x x x x x Indicators of need

Adjusting for unmet need – spline functions Utilisation Lower cut-off Upper cut-off x x x x x x x x x x x x x x Indicators of need

Utilisation NRAC Adjustment for unmet need – Circulatory Upper cut-off – 75% deprivation Indicators of need

Using SHe. S: step one - estimating prevalence Prevalence 0 0 0 X 0 x 0 0 x x x 0 X X 0 0 x 0 x x 0 x 0 0 0 0 x x 0 x 0 x Indicators of need

Using SHe. S: step two – utilisation on prevalence Utilisation Lower cut-off Upper cut-off x x x x x x x x x x x x x x Prevalence

Other techniques: • Variations method; • Counter-intuitive signs; • Variations method II.

Questions: • what other research is relevant and should be taken into account; • what priority should be given to alternative approaches; • how relevant is the question of determinants; • what evidence is there on determinants?

Illustrating the Concept of Unmet Need Acute MLC sub-group: 2 nd October 2014