Reevaluating Funding Mechanisms for UK Primary Care Trusts: A New Model of Secondary Care Usage Incorporating Lifestyle Data

This paper is concerned with modelling variations in the use of health-care services between small geographic areas. A range of potential explanatory variables are identified from a review of previous literature, ranging from social, economic, and demographic factors through access to services, and practitioner characteristics, to new measures of behaviour and lifestyle. Real admissions data for the city of Leeds relating to a variety of services over a three-year period are introduced to calibrate a series of utilisation models. It is argued that the strength of the goodness of fit makes these models potentially useful in the evaluation of resource allocation between service providers. By providing better global models of usage it is possible to examine small-area outliers to highlight areas where revealed demand, or usage, is not reflecting need as much as it should. In particular, this paper demonstrates the importance of lifestyle preferences in modelling the utilisation of health-care services.