On measures of deprivation and the spatial allocation of resources for primary health care

In this paper some of the conceptual and empirical issues in the specification and aggregation of deprivation measures used as a basis for resource allocation in the primary health sector are explored. The problems of deriving deprivation payments to general practitioners (GPs) from data pertaining to individuals are examined, and two empirical studies which draw out methodological issues are described. In the first study, a Bristol database is used to explore the spatial aggregation issue in ranking GP practices on a selected measure of deprivation. In the second, a database relating to English wards is used to investigate the sensitivity of deprivation payments to the statistical transformation and standardisation in the specification of the deprivation index. It is argued that the aggregation and specification issues should be confronted directly in the conceptual and practical developments of current approaches.