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Technical Note for Scotland Performs Indicators and Targets – National Indicator 23

This page relates to the 2007 version of the National Performance Framework. Information about the current version of the NPF is available on the Scotland Performs Home Page.

Scotland Performs National Indicator 23 - Reduce alcohol related hospital admissions by 2011

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Title

Alcohol-related hospital admissions per 100,000 population.

Associated Targets

Reduce alcohol-related hospital admissions by 2011.

Brief Description

The indicator measures the number of general acute inpatient and day case discharges per 100,000 population with an alcohol-related diagnosis as defined by selected World Health Organisation's International Classification of Diseases 10th revision (ICD10) codes. This is a measure of health harm caused by the misuse of alcohol. Discharges are used instead of admissions, as the discharge record is more complete.

Strategic Objective(s) to Which Indicator Relates

Healthier; Safer and Stronger.

Definitions of Keywords

Alcohol related conditions are defined by using the World Health Organization's International Classification of Diseases 10th Revision (ICD10). Alcohol related conditions used are: E24.4, E51.2, F10, G31.2, G62.1, G72.1, I42.6, K29.2, K70, K86.0, O35.4, P04.3, Q86.0, R78.0, T51.0, T51.1, T51.9, X45, X65, Y15, Y57.3, Y90, Y91, Z50.2, Z71.4, Z72.1. The lists of the ICD10 codes used in analysis of hospital data (general acute and psychiatric) codes have recently been revised. All historic data is based on the revised code list.

The rate per 100,000 population is calculated using the European Age Standardised Rate (EASR) methodology. The age standardised rate is the number of events that would occur in a standard population (per 100,000) if that population had the age-specific rates for a given area. The rates are standardised to the European Standard Population.

In December 2009 this indicator was revised and now records continuous inpatient stays. The overall effect on data trends is small but brings this indicator in line with the way ISD present data from the Scottish Morbidity Records 01 (SMR01) database:

http://www.drugmisuse.isdscotland.org/publications/local/CIS_FAQ.pdf

The revised indicator includes transfer cases but still excludes:

  • admissions to mental illness hospitals, psychiatric units and maternity hospitals.
  • patients resident outwith Scotland or those where NHS board or council area of residence is not known.

Evidence Source

Data Sources: Based on ISD Scottish Morbidity Records (SMR01) data.

Unit of measurement: Standardised rate per 100,000 population ( EASR).

Baseline and Past Trends

Alcohol related hospital admissions were steadily increasing over the decade that ended with the baseline year of 2006/07. The revised baseline figure for 2006/07 was 737 per 100,000, an increase of 38% from 1996/97 when the rate was 536 per 100,000.

Methodology for Data Source

The indicator reports continuous inpatient stays, rather than the numbers of patients.

The indicator reports general acute inpatient stays only. Psychiatric inpatient admissions with an alcohol-related diagnosis are not included due to concern over the consistency of this measure. The number of psychiatric hospital admissions may be falling due to more services being provided in the community, rather than a real fall in the number of alcohol-related psychiatric episodes.

The recording of alcohol misuse may vary from hospital to hospital. Where alcohol misuse is suspected but unconfirmed it may not be recorded by hospitals. Changes in recording practices may impact on the number of alcohol-related admissions recorded.

Alcohol-related admissions rates are subject to revision as there is no cut off for acceptance of SMR01 returns (although 99% are received within one year).

Data Ownership and Quality Assurance

National Statistics, produced by Information Services Division (ISD) Scotland.

Publication of Data

Alcohol-related hospital admission data are updated annually on:

http://www.alcoholinformation.isdscotland.org

Methodology for Recent Change Arrow on Scotland

This evaluation is based on: any difference within +/- 1.0% of last year's figure suggests that the position is more likely to be maintaining than showing any change. A decrease of 1.0% or more suggests the position is improving; whereas an increase of 1.0% or more suggests the position is worsening.

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