Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in England

e18769 Background: Delivery of high quality cancer care is associated with rising costs, both in earlier stages of the illness trajectory and at the end of life. A significant portion of the costs and health care utilisation occurs in the last year of life. Most publications to date have focused on costs in hospital. Little is known about the costs of care for cancer patients across the entire health service. The aim was to examine primary, secondary and acute health care utilisation and cost in the last 12 months of life and how these differ by cancer diagnosis and other patient characteristics among decedent patients aged 60 and over. Methods: We conducted a retrospective cohort study of people aged 60 years and over (N=26,077) who died in England between 2010 and 2017. We used routinely collected and linked data from primary care (Clinical Practice Research Datalink (CPRD) secondary and acute care, (Hospital Episode Statistics (HES), and death data (Office for National Statistics (ONS)). This provided a nationally representative sample of the English population. We analysed of healthcare utilisation and resource use amongst decedents by gender, primary cause of death, age, geography, socio-economic status and comorbidities. Results: Overall, 90.2 % of the cancer decedents were admitted in the hospital at least once in the last 12 months of life. About 50% of patients we admitted to hospital in the last month of life with 37.6 being admitted to the hospital more than once in the last month of life. The health care utilisation and costs increased sharply in the last month of life. life. The mean number of hospital admissions in the last year of life was 3.7 (SD, 5.8). Those dying of haematological cancers (N=2093) had highest number of hospital admissions (mean:7.2, SD:10.8) and longer average hospital stay (mean:36.7, SD:33.0) (mean:12.0, SD:14.4). Use of outpatient services was highest in the group dying of haematological cancers (mean:12.0, SD:14.4) whereas those dying of prostate cancer (N= 2197) had higher number of emergency (mean:2.0, SD: 1.9) and GP visits (mean:30.8, SD: 20.7). Healthcare costs were highest among haematological cancers and lowest among those dying of breast cancer. Proximity to death and comorbidities were the main contributors of end-of-life care health care utilisation and costs. Conclusions: This study uses large linked datasets (linked to the whole spectrum of hospital episode statistics) providing a comprehensive picture of healthcare services accessed by cancer patients at end of life in England. There is significant variation in use and cost of care for cancer patients in the last year and month of life. Further analysis of variation according to hospice, palliative, and social care service provision may identify strategies to address this variation.

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Osteoporosis hospital admissions varied across sub-regions but not seasons in England: Hospital Episode Statistics, 2008–2011

Public Health ◽

10.1016/j.puhe.2014.09.006 ◽

2014 ◽

Vol 128 (12) ◽

pp. 1125-1127

Author(s):

D. Chown ◽

I. Shiue

Keyword(s):

Hospital Admissions ◽

Hospital Episode Statistics ◽

Hospital Episode

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Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics

BMC Health Services Research ◽

10.1186/1472-6963-12-148 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 35

Author(s):

Kate J Fitzsimons ◽

Shumaila Mukarram ◽

Lynn P Copley ◽

Scott A Deacon ◽

Jan H van der Meulen

Keyword(s):

Cleft Lip ◽

Hospital Episode Statistics ◽

Hospital Episode

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Evaluating record linkage of birth registration and notification records to Hospital Episode Statistics: Singleton births in 2005 and 2006 across England

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1316 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Victoria Coathup ◽

Alison Macfarlane ◽

Maria Quigley

Keyword(s):

External Validity ◽

Hospital Admissions ◽

Economic Status ◽

Deterministic Algorithm ◽

Hospital Episode Statistics ◽

Birth Registration ◽

Hospital Episode ◽

Birth Records ◽

Administrative Datasets

Background with rationaleLinked administrative datasets are particularly useful within the field of perinatal epidemiology. By linking multiple datasets, researchers can create longitudinal datasets, which allow them to explore research questions relating to early exposures and outcomes later in life. Main AimThe aims of this study were to describe the methods used to deal with duplicate hospital admission records, assess the quality of linkage between babies birth registration records and subsequent hospital admissions, and to evaluate the potential bias that may be introduced as a result of these methods. MethodsThree routinely collected datasets were linked for use within this study and included data from birth registration, NHS Numbers for Babies (NN4B) and Hospital Episode Statistics (HES) for babies born in England between 1st January 2005 and 31st December 2006. A number of stages to cleaning were undertaken, including dealing with duplicate HES records and assessing the quality of the linkage using a deterministic algorithm. Internal and external validity was also assessed. ResultsThere were a total of 1,170,970 live, singleton births, occurring in NHS hospitals, to mothers who normally reside in England in 2005 and 2006 combined. Of these, approximately 92% were successfully linked with a HES birth record. Data quality was somewhat poorer in HES birth records compared to birth registration and NN4B. The quality assurance algorithms identified 1,456 incorrect linkages (<1%) and examination of external validity identified children that were not linked were slightly more likely to be born to mothers who were older and of higher socio-economic status. ConclusionIt is possible to create valuable longitudinal datasets allowing researchers to explore important questions about exposures and childhood outcomes using administrative datasets, however, missing data and coding errors and inconsistencies mean it is important that the quality of linkage is assessed prior to analysis.

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Management of iron deficiency anaemia in secondary care across England between 2012 and 2018: a real-world analysis of Hospital Episode Statistics

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101506 ◽

2020 ◽

pp. flgastro-2020-101506

Author(s):

Matthew James Brookes ◽

Angela Farr ◽

Ceri J Phillips ◽

Nigel John Trudgill

Keyword(s):

Iron Deficiency ◽

Postmenopausal Women ◽

Secondary Care ◽

Iron Deficiency Anaemia ◽

Hospital Admissions ◽

Design Method ◽

Hospital Episode Statistics ◽

Day Case ◽

Deficiency Anaemia ◽

Hospital Episode

ObjectiveIron deficiency anaemia (IDA) occurs in 2%–5% of men and postmenopausal women in the developed world and, if left untreated, can significantly impair quality of life or decompensate chronic illnesses. Approximately 10% of men and postmenopausal women with IDA have underlying gastrointestinal malignancy. This study identifies trends in the management of IDA in secondary care in England.Design/methodThe Hospital Episode Statistics database was used to analyse IDA-related hospital and outpatient admissions (elective and non-elective) in National Health Service England between April 2012 and March 2018. Outcome measures included rates of readmission, length of stay (LOS) and cost per admission.ResultsBetween 2012/2013 and 2017/2018, there was a 72% increase in hospital admissions for patients with a primary diagnosis of IDA and a 68% increase in hospital spells, with the number of cases being managed non-electively increasing by 58%. Non-electively managed patients had a longer LOS (3.10 vs 0.04 days, respectively) and increased rate of readmissions within 30 days (24.1% vs 6.6%) versus patients managed electively. Average day-case cost was £449 versus £1676 for non-elective admission. Across the 195 clinical commissioning groups (CCGs) in England, non-elective spells per 100 000 population demonstrated extensive and widening variability, ranging from 18 to 118 in 2017/2018 compared with 11–55 in 2012/2013.ConclusionThe current analysis highlights several opportunities to improve patient outcomes and reduce costs. There is an opportunity to improve day-case services by looking at the difference between CCGs and the variability in care and to reduce the number of non-elective admissions.

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Admissions for orthostatic hypotension: an analysis of NHS England Hospital Episode Statistics data

BMJ Open ◽

10.1136/bmjopen-2019-034087 ◽

2019 ◽

Vol 9 (11) ◽

pp. e034087 ◽

Cited By ~ 1

Author(s):

Eoin Duggan ◽

Roman Romero-Ortuno ◽

Rose Anne Kenny

Keyword(s):

Orthostatic Hypotension ◽

Hospital Admissions ◽

Hospital Episode Statistics ◽

Chronic Obstructive ◽

Age Group ◽

Obstructive Pulmonary Disease ◽

Hospital Episode ◽

International Classification Of Disease ◽

The Past ◽

Outpatient Appointments

ObjectivesTo determine whether admissions for orthostatic hypotension (OH) and its consequences, such as falls, have changed over the past 10 years in the National Health Service (NHS) England.SettingData from NHS England Hospital Episode Statistics, a database containing details of all admissions, accident and emergency attendances and outpatient appointments at NHS hospitals in England, were obtained and analysed.ParticipantsData on hospital admissions in NHS England, as defined by finished consultant episodes (FCEs), were examined between 2008 and 2017.Main outcome measuresFCEs for the following International Classification of Disease codes were examined: OH (I95.1), tendency to fall (R29.6), epilepsy (G40) and chronic obstructive pulmonary disease (COPD) (J44). The total number of FCEs was also examined.ResultsBetween 2008 and 2017, FCEs for OH rose from 14 658 to 30 759, a 110% increase. The greatest increase was in the over 75 years age group where FCEs went from 10 639 to 22 756, a 114% rise. The number of falls related FCEs in this age group rose from 61 841 to 89 622 (45%). Admissions for epilepsy and COPD rose by 7% and 35%, respectively.ConclusionsThe number of admissions for OH has risen dramatically over the past 10 years, as have admissions for falls and related disorders. This rise is out of proportion with admissions for other conditions such as epilepsy and COPD. We postulate that this relates to tighter blood pressure (BP) targets. This suggests caution in the application of recent BP targets to older, frailer adults.

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Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data

The British Journal of Psychiatry ◽

10.1192/bjp.185.4.334 ◽

2004 ◽

Vol 185 (4) ◽

pp. 334-341 ◽

Cited By ~ 81

Author(s):

Andrew Thompson ◽

Mary Shaw ◽

Glynn Harrison ◽

Davidson Ho ◽

David Gunnell ◽

...

Keyword(s):

Psychiatric Hospital ◽

Hospital Admissions ◽

Admission Rate ◽

Hospital Episode Statistics ◽

Policy Implications ◽

Service Development ◽

Depression And Anxiety ◽

Regional Variations ◽

Hospital Episode ◽

Reason For Admission

BackgroundThe assessment and reporting of national patterns of psychiatric hospital admissions is important for strategic service development and planning.AimsTo investigate patterns of psychiatric hospital admissions of patients aged 16–64 years in England.MethodWe used the Department of Health's national Hospital Episode Statistics data on admissions to National Health Service hospitals in England between April 1999 and March 2000, to investigate patterns by region, gender, age and diagnosis.ResultsThe annual admission rate for England was 3.2 per 1000 population. There were marked regional variations and rates were higher in males than in females. Depression and anxiety together were the most common (29.6%) reason for admission. Length of stay exceeded 90 days in 9.2% of admissions and 1 year in 0.9% (highest in London and for psychoses).ConclusionsDepression and anxiety together were the most frequent diagnoses leading to hospitalisation. There has been a reversal of the previously reported predominance of female admissions. Regional variations in activity and the significant numbers of patients remaining for long periods in acute’ in-patient care have important policy implications.

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Contribution of recurrent admissions in children and young people to emergency hospital admissions: retrospective cohort analysis of hospital episode statistics

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307771 ◽

2015 ◽

Vol 100 (9) ◽

pp. 845-849 ◽

Cited By ~ 10

Author(s):

Linda PMM Wijlaars ◽

Pia Hardelid ◽

Jenny Woodman ◽

Janice Allister ◽

Ronny Cheung ◽

...

Keyword(s):

Young People ◽

Chronic Conditions ◽

Chronic Condition ◽

Hospital Admissions ◽

Cohort Analysis ◽

Emergency Admission ◽

Hospital Episode Statistics ◽

Emergency Admissions ◽

Children And Young People ◽

Hospital Episode

ObjectiveTo examine the contribution of recurrent admissions to the high rate of emergency admissions among children and young people (CYP) in England, and to what extent readmissions are accounted for by patients with chronic conditions.DesignAll hospital admissions to the National Health Service (NHS) in England using hospital episode statistics (HES) from 2009 to 2011 for CYP aged 0–24 years. We followed CYP for 2 years from discharge of their first emergency admission in 2009. We determined the number of subsequent emergency admissions, time to next admission, length of stay and the proportion of injury and chronic condition admissions measured by diagnostic codes in all following admissions.Results869 895 children had an index emergency admission in 2009, resulting in a further 939 710 admissions (of which 600 322, or 64%, were emergency admissions) over the next 2 years. After discharge from the index admission, 32% of 274,986 (32%) children were readmitted within 2 years, 26% of these readmissions occurring within 30 days of discharge. Recurrent emergency admission accounted for 41% of all emergency admissions in the 2-year cohort and 66% of inpatient days. 41% of index admissions, but 76% of the recurrent emergency admissions, were in children with a chronic condition.ConclusionsRecurrent admissions contribute substantially to total emergency admissions. They often occur soon after discharge, and disproportionately affect CYP with chronic conditions. Policies aiming to discourage readmissions should consider whether they could undermine necessary inpatient care for children with chronic conditions.

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