Composite indicators may not be helpful in comparing health authorities

doi:10.1136/bmj.320.7229.252/b

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Mark Reilly, epidemiologist (Mark.Reilly@emailtees-ha.northy.nhs.uk),
Paul Johnstone, director of public health

Directorate of Public Health, Tees Health Authority, Poole House, Middlesbrough TS7 0NJ

EDITOR—Mulley's editorial1 on the Department of Health's comparative data for health authorities2 and hospitals3 provides a balanced and constructively critical view. We, too, endorse the national initiative and welcome the opportunities to understand variations in population health and some aspects of care. But we have serious reservations about the use of composite indicators to compare health authorities.

As one example, we refer to the composite indicator for five year survival for breast and cervical cancer. Two districts with …