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Publication of the annual Northern Ireland episode based acute hospital inpatient and day case activity data for 2009/10

Friday, 8 October 2010

The Department of Health, Social Services and Public Safety (DHSSPS) today published the Northern Ireland Episode Based Acute Hospital Inpatient and Day Case Activity Data for 2009/10.

The purpose of this publication, on episode based acute hospital inpatient and day case activity, is to complement data contained in the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity Statistics (2009/10) publication, issued on 26 August 2010 and available on the DHSSPS website.

While the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity Statistics (2009/10) publication is based on admissions to hospitals this publication is based on finished consultant episodes (FCEs).

The Episode Based Acute Hospital Inpatient and Day Case Activity Data shows detailed analysis at diagnostic and procedure level, within the Acute Programme of Care (PoC 1). In addition, episode based data in Northern Ireland can be compared with the equivalent Hospital Episode Statistics data published annually in England.

Key facts and figures for Northern Ireland Episode Based Acute Inpatient and Day Case Activity Data in 2009/10

Number of Finished Consultant Episodes Within the Acute Programme of Care

  • In 2009/10, there were 562,902 Finished Consultant Episodes (FCEs) in Northern Ireland hospitals within the Acute Programme of Care, compared with 517,023 in 2005/06 - an increase of 8.9%.
  • Of the 562,902 FCEs during 2009/10, 169,954 (30.2%) where admitted for day case treatment.
  • Over the last five years the number of day case episodes has risen by 9.8% from 154,759 in 2005/06 to 169,954 in 2009/10. Similarly, over the same period the number of inpatient episodes increased by 4.6% from 270,294 in 2005/06 to 282,745 in 2009/10.
  • The average length of an inpatient episode was 5.2 days in 2005/06; this has fallen to 4.6 days in 2009/10.

Primary Diagnosis

  • In 2009/10 there were 56,286 FCEs where a diagnosis of cancer or other neoplasm was recorded as the primary diagnosis – an increase of 8.2% when compared to 2005/06 (52,036).
  • Over the same period there has been a rise of 10.2% (increasing to 28,905 in 2009/10 from 26,224 in 2005/06) in the number of FCEs were the primary diagnosis recorded was influenza, pneumonia etc.
  • Finished consultant episodes where a diagnosis of ischaemic heart disease was recorded in a primary position, have decreased by 8.9% from 15,682 recorded in 2005/06 to 14,290 recorded in 2009/10.

Main Procedures/Interventions

  • There has been a rise in the number of FCEs where a hip procedure was the primary intervention. In 2005/06 there were 2,526 hip procedures carried out and this has increased by 14.4% in 2009/10 to 2,889.
  • The number of finished consultant episodes where a cataract procedure was carried out has decreased since 2005/06, when there were 8,530 cataract procedures carried out. In 2009/10 there were 7,627 cataract procedures carried out which is a decrease of 10.6%.

Notes to editors:

1. All published hospital inpatient activity data is available online.

2. About the data

  • A consultant episode is the time a patient spends in the continuous care of one consultant. The episode can be finished because of discharge, death or transfer, either to another consultant or another hospital. As a result, a patient may have more than one FCE during an admission to hospital (if transferred to the care of another consultant).
  • Episode based data is used to perform detailed analysis at diagnostic and procedure level, which may vary between each of the episodes that form an admission. Episode data is used to answer Assembly /Parliamentary questions, ad-hoc queries and for financial analysis. In addition, episode based data in Northern Ireland can be compared with the equivalent Hospital Episode Statistics data published annually in England.
  • Inpatient and day case episode data for all specialties within the acute services programme of care is collated monthly from each hospital’s Patient Administration System and is recorded in the Hospital Inpatient System (HIS). Each record within the HIS relates to an individual consultant episode and records details such as the date the patient was admitted the diagnosis of the patient and any interventions/procedures the patient underwent.
  • The total number of bed days has been calculated using the stay duration field within the Hospital Inpatient System; this is in contrast to the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity Statistics (2009/10) publication which uses specialty level bed occupancy data from the KH03a aggregate return.
  • In contrast to previous years Independent Sector activity carried out within HSC Hospitals has been excluded from the 2008/09 and 2009/10 HIS data.

3. Definitions

  • Admission: The number of Deaths and Discharges are used as an approximation to the count of admissions. HIS records contain the admission date along with the method of admission (i.e. whether the patient was admitted from a waiting list, or as an emergency, or by another method). Also recorded is the source of admission (e.g. from normal place of residence, from a nursing home, or from another hospital).
  • Day Case: An elective admission where the patient was treated during the course of a single day. Most day cases are episodes involving minor surgical procedures - the patient having been on a waiting list. HIS records contain a data item for patient classification, which enables day cases to be separately identified.
  • Elective Admission: An admission from a waiting list (including booked admissions), or a planned admission. As planned admissions are those deferred for medical reasons, these are not included in waiting time analyses.
  • Finished Consultant Episode (FCE): A period of continuous admitted patient treatment under the care of a consultant. If, during an admission, a patient is transferred from one consultant to another, a new Consultant Episode commences. An episode if considered to be finished if it ended before midnight on the last day of the HIS year (31 March). The HIS dataset for a particular year consists of all episodes which finished during the year, including those which began in previous years. Also stored are a much smaller number of records (approximately 2% of the total) for episodes, which began during the year, but were continuing at the end of the year. However, this latter group (the unfinished episodes) are normally excluded from analyses (for every unfinished episode there will, eventually, be a FCE recorded in a later data year).
  • Primary Diagnosis: The condition established as the main reason for admission after all investigations, diagnostic examinations and procedures have been carried out.
  • Procedure/Intervention: An operation or series of operations aimed at restoring or improving the health of a patient, as by correcting a malformation, removing diseased parts, implanting new parts, etc.
  • Bed Days: A day of bed occupation by an admitted inpatient (beds used for day cases admissions and regular day/night attenders are not included). HIS is frequently used to analyse bed occupancy as a measure of the resources expended by the Health Service. If there are 100 inpatients who each remain in hospital for 5 days, the bed days figure will be 500. The total number of bed days has been calculated using the stay duration field within the Hospital Inpatient System; this is in contrast to the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity Statistics (2009/10) publication which uses specialty level bed occupancy data from the KH03a aggregate return.
  • Average Length of Stay: A measurement of the average length of time spent in hospital. Day Cases and regular attenders are excluded from the calculation. Formula used as follows:

Total Inpatient Bed Days

Total Inpatients

4. This information was collated by Hospital Information Branch, DHSSPS.

Further information is available from:

Hospital Information Branch
Department of Health, Social Services and Public Safety
Annexe 2 Castle Buildings
Stormont
BT4 3SQ

Telephone: 028 90 522914

Email:

Internet:

5. Media queries to DHSSPS Press Office on 028 9052 0074, or out of office hours contact the Duty Press Officer via pager number 076 9971 5440 and your call will be returned.