MAS223 Statistical Modelling
Practical 4
This practical counts for 10% of your mark on this module. Submit your report on Black-
board by Monday 25th May, 4pm. Please make sure you hand-in on time. In line with
university policy, for every university-working-day late a submission is, the awarded mark will
be reduced. 5 working days after the deadline there is a cut-off after which a mark of 0 will be
returned.
This practical is assessed, so your submitted report must be entirely your own work. Do
not ask the lecturer or tutors any questions about this practical. Also be aware of
the University guidelines on plagiarism (https://www.sheffield.ac.uk/ssid/exams/plagiarism).
Your work may be cross-referenced for plagiarism with assignments from previous years, as well
as this year.
1 Background
In 2011, the UK Government announced plans for a major re-organisation of the National
Health Service. The Health and Social Care Bill 20111 included plans to abolish primary care
trusts, and transfer their control of the budget (about 80% of the total) to consortia of GPs
and other clinicians2. In justifying the plans, former Health Secretary Andrew Lansley argued
that “We don’t get the results we should compared with other European countries; if we did
we would save thousands of lives.”3 Other criticisms of previous health-care provision included
the claims “Someone in this country is twice as likely to die from a heart attack as someone in
France” and “survival rates from cervical, colorectal and breast cancer are amongst the worst
in the OECD”4. These claims themselves have been criticised, and it has been suggested that
life expectancy is a more reliable indicator of “health experience”5.
The World Health Organisation (WHO) published data on health expenditure in each coun-
try, together with outcomes such as life expectancy6. Some data has been extracted from the
WHO database, and is stored in the dataset who, within the R workspace MAS223.RData. As
well as expenditure, the dataset includes other variables that may influence health outcomes:
tobacco consumption, alcohol consumption, and obesity rates. The countries listed are the
member states of the Organisation for Economic Co-operation and Development (OECD)7
(with Luxembourg omitted, as not all data were available). The variables recorded were from
the WHO Global Health Observatory in February 2011.
• expenditure: total expenditure per person on health, measured in purchasing power
parity (PPP) international dollars. (Two countries with equal expenditure using this
measure should be able to buy, approximately, the same goods and services).
• life: life expectancy at birth, in years.
• tobacco: Percentage of tobacco user among adults ( ≥15 years), averaged over males and
females.
• alcohol: Alcohol consumption among adults (≥15 years) (litres of pure alcohol per year)
• obesity: Percentage of adults classified as obese ( ≥15 years), averaged over males and
females.
1
2 Tasks
1. Using the available data, assess the 2011 performance of UK healthcare compared to
healthcare in other OECD countries.
2. Write up your findings in a brief report (maximum of four pages, including graphs, but
excluding an appendix with R code). You will be graded on clarity of expression and
reasoning, as well as correctness of answers. Make sure you explain whether your results
suggest that the UK didn’t “get the results we should compared with other European
countries” (in 2011), as claimed by Andrew Lansley, and why you have reached this
conclusion.
3 References
1. Department of Health, 2011. Health and Social Care Bill 2011 [Online]. Available at:
www.dh.gov.uk/en/Publicationsandstatistics/
Legislation/Actsandbills/HealthandSocialCareBill2011 [Accessed 07/02/11].
2. BBC News, 2012. QA; The NHS shake-up. Available at:
www.bbc.co.uk/news/health-12177084 [Accessed 28/03/12].
3. BBC News, 2011. Andrew Lansley plays down risks of his NHS changes [Online]. Avail-
able at: www.bbc.co.uk/news/uk-politics-12318177 [Accessed 07/02/11].
4. Montgomorie, T., 2011. The myths and the facts about the NHS reforms [Online]. Avail-
able at: conservativehome.blogs.com/thetorydiary/2011/01/
the-myths-and-the-facts-about-the-nhs-reforms-savethenhs [Accessed 07/02/11].
5. Campbell, M., 2011. Watch out for abuse of statistics in health policy [Online]. Available
at www.guardian.co.uk/commentisfree/2011/feb/01/health-statistics-policy [Ac-
cessed 07/02/11].
6. World Health Organisation, 2011. WHO Global Health Observatory [Online]. Available
at apps.who.int/ghodata [Accessed 07/02/11].
7. OECD, 2011. Organisation for Economic Co-operation and Development [Online]. Avail-
able at www.oecd.org [Accessed 07/02/11].