ESRC Funding Success- A Spatial Microsimulation Model of Co-Morbidity

Health care policy

Dr. Karyn Morrissey of The Department of Geography and Planning, in conjunction with the East Kent Hospital Trust, has just been awarded £200,000 from the Economic and Social Research Council (ESRC) Secondary Data Analysis Initiative, Award to to develop a spatial microsimulation of co-morbidity for the East Kent region.

Informed health care policy requires spatially detailed data on health outcomes and patterns of health service utilisation. Health differentials across space arise due to the clustering of individuals who share similar demographic profiles and lifestyle choices into areas where similar contextual characteristics come into play, for example, area-based effects related to low levels of health service provision. To establish the key determinants of health status at both the individual and small area level a large variety of spatially referenced demographic, socio-economic and health data is required at the individual level. Although there are a number of national datasets that contain detailed health and health usage data, these data tend to be aspatial or at too high a spatial resolution to permit health data analysis at the required local level. One solution to this problem that has emerged in the last two decades is the growing use of spatial microsimulation models to represent and simulate health processes at the individual and small area level. Drawing on the experience my experience developing health microsimulation models and with the help of Paul Williamson and Alex Singleton this project seeks to develop a spatial microsimulation for England to meet the information needs of health policymakers and practitioners. Collaboration with the Director of Information in East Kent Hospital Trust has identified the increased rates of patients presenting with two or more diseases (co-morbidity) as a pressing issue, of direct policy relevance, that requires detailed spatial analysis. Co-morbidity is associated with a significant decline in both life expectancy and quality of life and increased costs in the provisioning of health services for individuals. The World Health Organisation has identified increased rates of co-morbidity as a major challenge for health policy. Utilising data holdings made available to academics via the ESRC-supplied data services, this project will develop a spatial microsimulation model of co-morbidity for England. The project, In collaboration with EKHT, will specifically examine rates  of co-morbidity for the East Kent region.

Depression in Ireland and a visit home – a tale of proximity

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Quay Street, Galway

Post by Dr Karyn Morrissey

For the last three days (28th-30th of August ), I have been at the 41st British-Irish Regional Science Association Conference, hosted at the National University of Ireland, Galway. Hailing from Galway, I was doubly excited to present my findings at such an important conference and have my Mom and Dad pander to my every need for a few days!

The paper I presented reported on my research on admissions to acute psychiatric hospitals for depression in Ireland.  Ireland has traditionally reported high levels of mental illness and admissions to acute psychiatric hospitals. Indeed, at the turn of the 20th Century, 1% of 15 to 35 year old males were housed in a mental ‘asylum’ in Ireland. These high rates of reported psychiatric illness are what prompted my research.

My research sought to determine the factors which differentiate individuals with depression who seek acute psychiatric services from those who do not seek these services. Using spatial microsimulation techniques my research found that within my sample of individuals with depression, females, older individuals, those with higher education and interestingly those closer to a psychiatric hospital were more likely to be admitted to an acute psychiatric hospital. This would indicate that access to psychiatric services is a determinate in whether individuals seek acute help. Such a finding is interesting for two reasons – it may demonstrate that individuals without services are experiencing a service gap, but it may also indicate that living closer to an acute service leads to over utilisation and over-referral. So Geography matters in this relationship.

Thus, whilst happy that my research shows an interesting relationship between proximity to acute care and the uptake of these services – this research also shows that there is a lot more work to be done to understand these differences in access to psychiatric care and to address inequalities here.

So it’s back to the drawing board…and back to the internet to look for my next conference in Galway!