Public Health Directorate, NHS Inner North West London, Westminster, UK.
BMC Public Health. 2011 Sep 28;11:738. doi: 10.1186/1471-2458-11-738.
Postcode lotteries in health refer to differences in health care between different geographic areas. These have been previously associated with clinical services. However there has been little documentation of postcode lotteries relating to preventative health care services. This paper describes a postcode lottery effect in relation to the NHS Health Checks Programme (a national cardiovascular screening programme in England) in eight PCTs in the North West sector of London.
A descriptive cross-sectional analysis of the Health Checks Programme was carried out in eight PCTs in North West London using a structured data-collecting instrument.
The analysis found variation in the implementation of the national Health Checks Programme in terms of: the screening approach taken; the allocated budget (which varied from £69,000 to £1.4 million per 100,000 eligible population); payment rates made to providers of Health Checks; tools used to identify and measure risk of cardiovascular disease and diabetes; monitoring and evaluation; and preventative services available following the health check.
This study identifies a postcode lottery effect related to a national public health programme. Although it is important to allow enough flexibility in the design of the Health Checks Programme so that it fits in with local factors, aspects of the programme may benefit from greater standardisation or stronger national guidance.
健康领域的邮政编码彩票是指不同地理区域之间医疗保健的差异。这些差异此前与临床服务有关。然而，关于与预防保健服务相关的邮政编码彩票的记录很少。本文描述了与国民保健制度健康检查计划（英格兰的国家心血管筛查计划）相关的邮政编码彩票效应，该计划涉及伦敦西北部的 8 个 PCT。
使用结构化数据收集工具，对伦敦西北部的 8 个 PCT 中的国民保健制度健康检查计划进行描述性横断面分析。
分析发现，国家健康检查计划的实施存在差异，包括：采取的筛查方法；分配的预算（从每个符合条件的 10 万人中 69000 英镑到 140 万英镑不等）；支付给健康检查提供者的费用率；用于识别和衡量心血管疾病和糖尿病风险的工具；监测和评估；以及健康检查后的预防服务。
本研究确定了与国家公共卫生计划相关的邮政编码彩票效应。尽管在健康检查计划的设计中允许足够的灵活性，以使其适应当地因素很重要，但该计划的某些方面可能受益于更大的标准化或更强有力的国家指导。
