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Episode Statistics (episode + statistics)

Distribution by Scientific Domains
Medical Sciences87%

Kinds of Episode Statistics

  • hospital episode statistics
    		•

    Selected Abstracts

    Social marketing in action,geodemographics, alcoholic liver disease and heavy episodic drinking in Great Britain

    INTERNATIONAL JOURNAL OF NONPROFIT & VOLUNTARY SECTOR MARKETING, Issue 3 2007
    Jane Powell
    This paper explores the use of geodemographic population classifications to identify and predict ,hotspots' of Great Britain (England, Scotland and Wales) prone to greater than expected alcoholic liver disease. MOSAIC geodemographic codes were overlaid onto Hospital Episode Statistics (HES) for Great Britain. The HES data included gender, MOSAIC Type, MOSAIC Code, postal and local authority district, month and year of birth, ethnic origin, Primary Care Trust and GP code. Analysis demonstrated that some geodemographic classifications of the population were over-represented for alcoholic liver disease episodes. These groups had low socio-economic and socio-cultural status, lived in areas of high deprivation and disadvantage. Manchester followed by Liverpool and Hull had the highest estimated patient group size in England and Hart, Surrey Heath and Wokingham the three lowest (indicating low expected levels of alcoholic liver disease compared with average). Analysis of the same data was also carried out at postcode level for Manchester indicating ,hotspots' for alcoholic level disease at street level. This analysis exemplifies the ways in which geodemographic data might be usefully applied to routine health service data to enhance service planning, delivery and improved targeting of information in harder to reach populations. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Hepatitis C in ethnic minority populations in England

    JOURNAL OF VIRAL HEPATITIS, Issue 6 2008
    A. G. Mann
    Summary., The aim of the study was to investigate the differing epidemiology of hepatitis C-related end-stage liver disease in ethnic minorities in England. We used Hospital Episode Statistics from 1997/98 to 2004/05 to directly age-standardize numbers of episodes and deaths from hepatitis C-related end-stage liver disease in ethnic groups using the white English population as standard and the age-structured population by ethnic group from the 2001 Census. We estimated the odds of having a diagnosis of end-stage liver disease amongst hepatitis C-infected individuals in each ethnic group compared with whites using logistic regression. The main outcome measures were age-standardized morbidity and mortality ratios and morbidity and mortality odds ratios. Standardized ratios (95% confidence interval) for hepatitis C-related end-stage liver disease ranged from 73 (38,140) in Chinese people to 1063 (952,1186) for those from an ,Other' ethnic group. Amongst individuals with a diagnosis of hepatitis C infection, the odds ratios (95% CI) of severe liver disease were 1.42 (1.13,1.79), 1.57 (1.36,1.81), 2.44 (1.85,3.22), 1.73 (1.36,2.19) and 1.83 (1.08,3.10) comparing individuals of Black African, Pakistani, Bangladeshi, Indian and Chinese origin with whites, respectively. Ethnic minority populations in England are more likely than whites to experience an admission or to die from severe liver disease as a result of hepatitis C infection. Ethnic minority populations may have a higher prevalence of hepatitis C or they may experience a poorer prognosis because of differential access to health services, longer duration of infection or the prevalence of co-morbidities. [source]

    Provision of radical pelvic urological surgery in England, and compliance with improving outcomes guidance

    BJU INTERNATIONAL, Issue 10 2009
    Erik K. Mayer
    OBJECTIVE To investigate compliance with Improving Outcomes Guidance (IOG) for radical pelvic surgery in England, and explore the pattern of service provision for radical cystectomy (RC) and radical prostatectomy (RP) before and after the introduction of IOG. METHODS For the period 2000/01,2006/07, all admissions for RC and RP were extracted from Hospital Episode Statistics (HES). At the institutional level, the numbers of RC and RP cases were combined to assess adherence to IOG. The IOG catchment populations for each institution were calculated by linking HES data to census ward population data. The pattern of service provision for RC and RP was independently assessed by assigning institutions into low-, medium- and high-volume groups of roughly equal volumes a priori, based on the ascending order of annual RC or RP rate, respectively. For RC it was also possible to explore the between-institution referral activity for RC by identifying the ,final endoscopic bladder procedure' that occurred immediately before the RC for each patient. This gave an indication of where the diagnosis and decision for RC had been made. RESULTS The percentage of institutions achieving the recommended IOG minimal case volume of 50 per year increased significantly between 2000/01 and 2006/07 (36% in odds per year, P < 0.001; odds ratio 1.36, 95% confidence interval 1.24,1.50), although absolute numbers remained relatively low (34% in 2006/07). Only one institution had a catchment population greater than the recommended 1 million. The total number of institutions performing RC decreased significantly over the years (P = 0.03), whereas for RP the decrease was not significant (P = 0.6). The decrease reflected a decline in the number of low-volume institutions, both for RC and RP, although this decline was not more than expected by chance. There had been a significant increase in the percentage of patients referred to another provider for their RC, from 5.5% in 2000/01 to 19.6% in 2006/07 (28% rise in odds per year, P < 0.001: odds ratio 1.28, 95% confidence interval 1.23,1.33). CONCLUSION There was evidence of centralization of radical pelvic urological surgery, although it is only relatively recently that this seems to have taken place with any certainty. The absolute numbers of providers achieving the IOG minimum caseload standard was relatively low. What impact this has had, if any, on the quality of patient care is yet to be fully determined. [source]

    Decline in admission rates for acute appendicitis in England,

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2003
    J. Y. Kang
    Background: The incidence of acute appendicitis declined in western countries between the 1930s and the early 1990s. The aim of this study was to determine time trends in hospital admissions for acute appendicitis in England between 1989,1990 and 1999,2000, and in population mortality rates for appendicitis from 1979 to 1999. Methods: Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data from the Office for National Statistics. Results: Between 1989,1990 and 1999,2000, age-standardized hospital admission rates for acute appendicitis decreased by 12·5 per cent in male patients and by 18·8 per cent in female patients. The proportions of admissions that resulted in operation remained stable. Admission rates for non-specific mesenteric lymphadenitis fell. Admission rates for abdominal pain increased between 1989,1990 and 1995,1996, at which time the International Classification of Diseases codes changed. Between 1995,1996 and 1999,2000, admission rates for abdominal pain declined. Analysis of age-specific admission rates for acute appendicitis and abdominal pain from 1989,1990 to 1995,1996 showed that the decline in acute appendicitis could not be accounted for by a change in diagnostic practice. Mortality rates for acute appendicitis remained stable over the study period. Conclusion: Admission rates for acute appendicitis declined over the study period. This decline cannot be explained by reclassification. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    The increasing hospital disease burden of haemochromatosis in England

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
    M. L. COWAN
    Summary Background, Hereditary haemochromatosis is a preventable cause of liver disease with an increasing disease burden. Aims, To investigate time trends for hospital admission ascribed to haemochromatosis in England during the period from 1989/1990 to 2002/2003 and mortality from 1979 to 2005. Methods, Hospital admission data, relating to both in-patients and day-cases, were obtained from the Hospital Episodes Statistics service. Mortality rates for England and Wales were provided by the Office for National Statistics. Results, Haemochromatosis is an uncommon cause for hospital admission. Age-standardized in-patient admission rates increased over the study period by 269% in men and by 290% in women: (from 0.64 to 2.36 and from 0.21 to 0.81 per year per 100 000). The increase in age-standardized day-case admission rates was even higher (men: from 2.78 to 34.9 per year per 100 000, 1155%; women: from 0.58 to 11.67 per year per 100 000, 1924%). Haemochromatosis was recorded as an uncommon cause of death. Conclusions, Hospital in-patient and day case admissions for haemochromatosis increased markedly over the study period while mortality remained low. Both admission rates and mortality were higher in men than in women. The increase in admission rate may reflect improved recognition and diagnosis of iron overload disorders following identification of the HFE gene. Aliment Pharmacol Ther,31, 247,252 [source]

    Surgery for menorrhagia within English regions: variation in rates of endometrial ablation and hysterectomy

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2009
    DA Cromwell
    Objective, To examine variation between English regions in the use of surgery (endometrial ablation or hysterectomy) for the treatment of menorrhagia. Design, Analysis of Hospital Episodes Statistics (HES) data to produce rates of surgery for English Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs). Population, Women aged between 25 and 59 years who had endometrial ablation or hysterectomy for menorrhagia between April 2003 and March 2006 in English NHS hospitals. Methods, Multilevel Poisson regression was used to determine the level of systematic variation in the regional rates of surgery and their association with regional characteristics (deprivation, service provision and mix of surgical procedures). Main outcome measure, Age-standardised annual rates of surgery. Results, The English rate of surgery for menorrhagia was 143 procedures per 100 000 women. Surgical rates within SHAs ranged from 52 to 230 procedures per 100 000 women, while rates within PCTs ranged from 20 to 420 procedures per 100 000 women. While, 60% of all procedures were endometrial ablations, the proportion across SHAs varied, ranging from 46% to 75%. Surgery rates were associated with the regional characteristics, but only weakly, and risk adjustment reduced the amount of unexplained variation by <15% at both SHA and PCT levels. Conclusion, Regional differences in surgical rates for menorrhagia have persisted despite changes in practice and improved evidence, suggesting there is scope for improving the management of menorrhagia within England. [source]

    Patient outcomes and length of hospital stay after radical prostatectomy for prostate cancer: analysis of Hospital Episodes Statistics for England

    BJU INTERNATIONAL, Issue 5 2007
    Andrew Judge
    OBJECTIVE To investigate the morbidity and mortality after radical prostatectomy (RP) in relation to the numbers of RPs carried out at individual hospitals, as recent studies of complex surgery report worse outcomes in low-volume hospitals, and there has been a large increase in RPs for localized prostate cancer. METHODS We analysed hospital episode statistics data for all 18 027 RPs in English National Health Service hospitals between 1997 and 2004. RESULTS In multivariate analysis, there was a U,shaped association of hospital volume with mortality (P for nonlinear trend, 0.004), but this finding was based on only 59 (0.3%) deaths. The mean length of stay was 6 days and decreased by 2.96% (95% confidence interval, CI, 1.98,3.92; P < 0.001) per quintile increase in hospital volume. In all, 16.1% of men had 30-day in-hospital complications; 20.3% were readmitted with complications within a year. The odds of 30-day in-hospital wound/bleeding complications decreased by 6% (95% CI 1,11; P = 0.02), and miscellaneous medical complications decreased by 10% (0,19; P = 0.04) per increase in hospital volume quintile. For re-admissions within a year, the hazard of vascular complications decreased by 15% (6,22; P = 0.001), wound/bleeding complications decreased by 8% (2,13; P = 0.01) and genitourinary complications decreased by 5% (2,8; P = 0.002), per increase in hospital volume quintile. CONCLUSION In men undergoing RP the length of hospital stay and rates of some short- and long-term postoperative complications afterward are lower in high-volume hospitals. The magnitudes of these effects on the outcomes studied may be too small and inconsistent to indicate a policy of selective referral to high-volume hospitals. Quality of life and oncological outcomes, however, could not be investigated in this dataset. [source]

    Feasibility study of multicentre comparison of NHS hospital pharmacy computer data

    BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 1 2000
    Pauline Debra Walker
    Aims This study aims to determine the feasibility of collecting, collating and analysing drug expenditure data from a sample of acute hospitals in England. Methods The hospital pharmacy computer system was used to report on drug expenditure from 16 hospitals throughout England for a 2 year period. These data were analysed as a whole and hospital episode statistics were correlated to hospital drug costs. Results Hospital outpatient costs were found to be approximately one third of hospital inpatient costs. Cardiovascular drugs accounted for the greatest increase in expenditure for both inpatients and outpatients (25%). The most expensive therapeutic area of drug use across all sites was anti-infectives. The average daily number of occupied beds explained 55% of the variation in inpatient expenditure and the number of outpatient (including Accident and Emergency) attendances explained 60% of the outpatient drug expenditure. Conclusions This project has confirmed the feasibility of collecting, collating and analysing hospital drug expenditure and identified some interesting patterns and trends in hospital drug use. Hospital activity is reflected in hospital drug costs. [source]