Scottish Government

Reduce alcohol related hospital admissions

DESCRIPTION:

The indicator measures the number of general acute inpatient and day case stays per 100,000 population with an alcohol-related diagnosis. This is a measure of health harm caused by the misuse of alcohol. Stays are used instead of admissions, as the stay record is more complete.

SOURCE:

ISD Scottish Morbidity Records (SMR01) data

This is a National Statistics publication, produced by Information Services Division (ISD) Scotland.

Alcohol-related hospital admission data are updated annually on:

http://www.isdscotland.org/Health-Topics/Drugs-and-Alcohol-Misuse/Publications/

Unit of measurement: European Age-standardised Rate per 100,000 population (EASR).

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.scotpho.org.uk/publications/overview-of-key-data-sources/scottish-national-data-schemes/hospital-discharges

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.

To allow comparison between geographical areas and over time, figures are presented as rates per 100,000 and are standardised to a European Standard Population (ESP) distribution. Unlike using crude rates, this takes account of changes to population distributions over time or differences in populations between geographic areas.

Eurostat has revised the ESP to reflect the ageing of populations since it was first introduced in 1976.  Alcohol-related hospital statistics now use the ESP2013. Admission rates based on the new ESP has been calculated retrospectively to 1997-8. Rates reported using ESP2013 are not comparable to those published in previous years using ESP1976.

The indicator reports general acute inpatient stays only. Psychiatric inpatient stays with an alcohol-related diagnosis are not included due to concern over the consistency of this measure. The number of psychiatric hospital stays 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 stays recorded.

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

DEFINITIONS:

Alcohol related conditions are defined by using the World Health Organization's International Classification of Diseases 10th Revision (ICD10): http://www.who.int/classifications/icd/en/

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. Eurostat has revised the European Standard Population (ESP) to reflect the ageing of populations. Alcohol-related hospital statistics now use ESP2013.

Previous annual alcohol-related hospitalisation statistics have referred to continuous inpatient stays (CIS) for alcohol-related conditions as ‘discharges’. In this year’s report these are referred to as ‘stays’; the actual measure remains unchanged however. The National Indicator uses the term ‘admissions’ for clarity.

BASELINE AND PAST TRENDS:

The baseline year is 2006/07 as this is the last data point before the first term of the current administration. The baseline figure is 809 per 100,000.

The number of general acute inpatient and day case stays per 100,000 population with an alcohol-related diagnosis:

r=revised; p=provisional

CRITERIA FOR RECENT CHANGE ARROW:

This evaluation is based on: any difference within +/- 10 per 100,000 of last year's figure suggests that the position is more likely to be maintaining than showing any change. A decrease of 10 per 100,000 or more suggests the position is improving; whereas an increase of 10 per 100,000 or more suggests the position is worsening.

For information on general methodological approach, please click here.

FUTURE ISSUES OR REVIEWS:

No issues.

ASSOCIATED TARGET:

Target: Reduce alcohol-related hospital admissions by 2011.

End point: 2010/11 data point