Isle of Wight Joint Strategic Needs Assessment: Core Dataset 2009
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1 Isle of Wight Joint Strategic Needs Assessment: Core Dataset 2009 Domain: Burden of Ill Health Indicator: Hospital Admissions - Top 10 Causes Sub-Domain: Misc Indicator References: JSNA Core Dataset number 32 Sub-sub- Domain: All Causes Data Source: Indicator definition: Isle of Wight Primary Care Trust see below Isle of Wight Residents: Hospital Admissions by Method of Admission: Admission Method Admissions % of Total Examples Emergency % pneumonia, heart attacks, head injuries Elective % cataract procedures, cancer treatments Non Emergency, Non Elective % childbirth and related Total % Isle of Wight Residents: All Hospital Admissions by Cause of Admission (Primary Diagnosis) - Classified by ICD-10 Chapter: ICD-10 Chapter Title Admissions - All A00-B99 Certain infectious and parasitic diseases 410 C00-D48 Neoplasms 2405 D50-D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism 263 E00-E90 Endocrine, nutritional and metabolic diseases 295 F00-F99 Mental and behavioural disorders 511 G00-G99 Diseases of the nervous system 608 H00-H59 H59 Diseases of the eye and adnexa 1329 H60-H95 Diseases of the ear and mastoid process 220 I00-I99 Diseases of the circulatory system 1913 J00-J99 Diseases of the respiratory system 1840 K00-K93 Diseases of the digestive system 5301 L00-L99 Diseases of the skin and subcutaneous tissue 681 M00-M99 Diseases of the musculoskeletal system and connective tissue 2226 N00-N99 Diseases of the genitourinary system 1802 O00-O99 Pregnancy, childbirth and the puerperium 1655 P00-P96 Certain conditions originating in the perinatal period 421 Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities 91 R00-R99 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 2749 S00-T98 Injury, poisoning and certain other consequences of external causes 2133 V01-Y98 External causes of morbidity and mortality Z00-Z99 Factors influencing health status and contact with health services 1764 U00-U99 Codes for special purposes Not yet coded (e.g. because patients not yet discharged) 588 Total page 1
2 congenital malformations, etc ear and mastoid process Isle of Wight PCT: All Hospital Admissions by International Classification of Diseases (ICD 10) Chapter: : Persons, All Ages number of admissionsions 0 blood, bloodforming organs, immune endocrine, nutritional and metabolic infectious and parasitic diseases perinatal conditions mental and behavioural disorders nervous system skin and subcutaneous tissue eye and adnexa pregnancy & childbirth factors influencing health status and contact with genitourinary system respiratory system circulatory system injury, poisoning, other external causes musculoskeletal system cancers symptoms, etc, not elsewhere classified digestive system page 2
3 Isle of Wight Residents: Emergency Hospital Admissions by Cause of Admission (Primary Diagnosis) - Classified by ICD-10 Chapter: Blocks Title Admissions - Emergency A00-B99 Certain infectious and parasitic diseases 355 C00-D48 Cancers 422 D50-D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism 149 E00-E90 Endocrine, nutritional and metabolic diseases 200 F00-F99 Mental and behavioural disorders 439 G00-G99 Diseases of the nervous system 287 H00-H59 Diseases of the eye and adnexa 23 H60-H95 Diseases of the ear and mastoid process 47 I00-I99 Diseases of the circulatory system 1531 J00-J99J99 Diseases of the respiratory system 1497 K00-K93 Diseases of the digestive system 1305 L00-L99 Diseases of the skin and subcutaneous tissue 239 M00-M99 Diseases of the musculoskeletal system and connective tissue 340 N00-N99 Diseases of the genitourinary system 537 O00-O99 Pregnancy, childbirth and the puerperium 104 P00-P96 Certain conditions originating in the perinatal period 63 Q00-Q99Q99 Congenital malformations, deformations and chromosomal abnormalities 17 R00-R99 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 1659 S00-T98 Injury, poisoning and certain other consequences of external causes 1850 V01-Y98 External causes of morbidity and mortality Z00-Z99 Factors influencing health status and contact with health services 85 U00-U99 Codes for special purposes Not coded (e.g. because patients not yet discharged) 352 Total page 3
4 congenital malformations, etc eye and adnexa Isle of Wight PCT Emergency Hospital Admissions by International Classification of Diseases (ICD 10) Chapter: : Persons, All Ages number of admissions 0 ear and mastoid process perinatal conditions factors influencing health status and contact with pregnancy & childbirth blood, bloodforming organs, immune endocrine, nutritional and metabolic skin and subcutaneous tissue nervous system musculoskeletal system infectious and parasitic diseases cancers mental and behavioural disorders genitourinary system digestive system respiratory system circulatory system symptoms, etc, not elsewhere classified injury, poisoning, other external causes page 4
5 Isle of Wight Residents: Top Ten Causes of Hospital Admissions - Classified by ICD Code: Emergency Admissions Admission Ranking ICD Code Description Admissions 1 J181 Lobar pneumonia, R104 Other and abdominal pain R074 Chest pain, N390 Urinary tract infection, site not specified I48X Atrial fibrillation and flutter S099 Unspecified injury of head K529 Noninfective gastroenteritis and colitis, I219 Acute myocardial infarction, S7200 Fracture of neck of femur B349 Viral infection, 162 Total 2077 Isle of Wight PCT Emergency Hospital Admissions by International Classification of Diseases (ICD 10) Code: : Persons, All Ages number of admissions Lobar pneumonia, Other and Chest pain, Urinary tract Atrial fibrillation Unspecified Noninfective Acute Fracture of neck Viral infection, infection, site and flutter injury of head of femur-cl. abdominal pain not specified gastroenteritis and colitis, myocardial infarction, page 5
6 Isle of Wight Residents: Top Ten Causes of Hospital Admissions - Classified by ICD Code: Elective and non-emergency Admissions Admission Ranking ICD Code Description Admissions 1 H269 Cataract, Z380 Singleton, born in hospital M179 Gonarthrosis, K573 Diverticular disease of large intestine without perforation or abscess K029 Dental caries, Z080 Follow-up examination after surgery for malignant neoplasm G560 Carpal tunnel syndrome M169 Coxarthrosis, K449 Diaphragmatic hernia without obstruction or gangrene R31X Unspecified haematuria 230 Total 4137 Isle of Wight PCT Elective and non-emergency Hospital Admissions by International Classification of Diseases (ICD 10) Code: : Persons, All Ages number of admissions Cataract, Singleton, born Gonarthrosis, in hospital Diverticular dis of large intestine without perf or abscess Dental caries, Follow-up examination after surgery for malignant neoplasm Carpal tunnel syndrome Coxarthrosis, Unspecified haematuria Diaphragmatic hernia without obstruction or gangrene page 6
7 COMMENTARY All hospital admissions are 'coded' to a specific cause of admission using the standard International Classification of Disease (ICD) codes. This classification is divided into 21 Chapters, each of which contains a large number of specific diagnosis codes. Each hospital admission is allocated a 'Primary Diagnosis' code, which represents the main condition for which hospital treatment is required, and up to 12 'Secondary Diagnosis' codes. All the analysis above is of Primary Diagnosis codes. Admissions i are further classified by method of admission i - i.e. whether they are: - emergency admissions: where admission is at short notice because of clinical need; - elective admissions: where the decision to admit is at a different time from the actual admission; - non-elective and non-emergency admissions: for example, childbirth. The data and charts above show the following breakdowns, for hospital admissions of IW residents: - Breakdown by method of admission. Emergency admissions comprised 39% of total admissions. - Breakdown by cause of admission by ICD chapter -for All Admissions. Diseases of the digestive system comprised the largest single group of admissions but this disease chapter does include dental treatments, as well as ulcers and gallbladder conditions. - Breakdown by cause of admission by ICD chapter - for Emergency Admissions. When 'unclassified symptoms' are excluded, the largest groups of admissions were for injuries, circulatory disease (including heart attacks) and respiratory disease (including pneumonia). - Breakdown by cause of admission by ICD Code -for Emergency Admissions. Main causes of admission included pneumonia, chest pain, heart conditions and fracture of neck of femur (hip). - Breakdown by cause of admission by ICD Code -for Elective and non-emergency Admissions. Main causes of admission included cataract procedures, childbirth and dental treatments. page 7
8 INDICATOR DEFINITION Indicator: Definition: Main Causes of Hospital Admission Hospital admissions by cause (by ICD (International Statistical Classification of Diseases) Chapter and Code) Numerator (number of hospital admissions of people resident in the specified area who were admitted in the specified period (including those not yet people or events) discharged). NB: each admission is counted only once, but if a person is admitted more than once then each of their admissions is counted. Denominator (total population or events) Geographic Coverage All Ages by Gender NB: no admission rates are shown above. Primary Care Trust Time period Data Source(s) Isle of Wight Primary Care Trust Significance for Health It is not possible to draw conclusions purely from hospital admission numbers. Factors that might affect the Accuracy of this Indicator page 8
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