Coping with your coronary heart disease target.

ABSTRACT

The Scottish targets for coronary heart disease are examined in detail from the point of view of a Health Board. It is suggested that even though the target refers to the under 65 age group, further age/sex standardisation is needed for fair comparison. A least-squares regression technique is also recommended as a means of reducing the effect of atypical rates in baseline or target years. The targets adopted do not make it clear whether Health Boards should aim for a target in terms of the percentage fall, or should aim to be below an absolute level by the target year. The specific targets imply that resources will have to be concentrated in people of late middle age, particularly males, to the detriment of preventive activities in younger age groups. It seems necessary to emphasise that targets are not an end in themselves but merely an indicator of progress. Monitoring progress towards achieving the target could be achieved by assuming a linear fall in rate between baseline and target years, to produce annual intermediate targets. A health board's progress towards the final target can then be annually monitored by comparison of its regressed age-sex standardised rate with the intermediate target.