Alcohol related hospital activity
As part of the Local Alcohol Profiles for England, the Knowledge and Intelligence Team (North West) calculates the number of men and women admitted to hospital each year for alcohol-specific (conditions where alcohol is causally implicated in all cases of the condition) and alcohol-related conditions (alcohol-specific conditions plus those where alcohol is causally implicated in some but not all cases), yielding a period prevalence estimate of the number of persons admitted to hospital at least once during the course of a financial year. The analysis is carried out using data from the Health and Social Care Information Centre – Hospital Episode Statistics (HES) and Office for National Statistics (ONS) – Mid Year Population Estimates. There can be up to 20 diagnosis codes for a single episode, and one individual can have multiple episodes in a given year. As such, rules are used to avoid double counting of people for statistics which describe the number of people admitted to hospital for alcohol related conditions.
There are two definitions of alcohol-related hospital admissions used in the health profiles;
- Narrow definition: Persons admitted to hospital where the primary diagnosis is an alcohol-attributable code or one of the secondary codes is an external alcohol-attributable code.
- Broad definition: Persons admitted to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol-attributable code.
It should be noted that hospital admission data can be coded differently in different parts of the country. Moreover, in some cases, details of the patient’s residence are insufficient to allocate the patient to a particular area and in other cases the patient has no fixed abode. These cases are included in the England total but not in the smaller area (e.g. CCG level). Finally, some indicators are person based and others are admission based. For example, the number of people admitted to hospital due to alcohol-related conditions per 100,000 European Standard Population is a person-specific measure whilst the number of admission episodes for alcohol-related conditions per 100,000 European Standard Population is an admission-specific measure.
In NHS Crawley CCG in 2014/15, 285 people were admitted at least once to hospital for an alcohol-specific condition, at a rate of 282.4 people per 100,000 European Standard Population (ESP 2013) (95% CI: 249.7 – 318.1 people). This was similar to NHS Coastal West Sussex CCG (314.3 people admitted per 100,000 ESP 2013, 95% CI: 298.3 – 330.8 people), NHS Horsham and Mid Sussex CCG (229.8 people admitted per 100,000 ESP 2013, 95% CI: 210.2 – 250.8 people) and overall in the South East region for the same period (279.6 people admitted per 100,000, 95% CI: 276.1 – 283.2 people). However, the NHS Crawley CCG rate of people admitted for alcohol-specific conditions was significantly lower than the rate for England in the same period (364.4 people admitted per 100,000 ESP 2013, 95% CI: 362.8 – 366.1 people). The chart below shows the annual trend data for West Sussex CCGs between 2010/11 and 2014/15 for persons admitted to hospital for alcohol-specific conditions. The chart indicates that there is an upward trend in NHS Crawley CCG in the first three years of the period, although differences may not be significant across individual years. However, there was a significant increase in the rate of alcohol-specific hospital admissions in the CCG between 2012/13 (278 people admitted per 100,000 ESP 2013, 95% CI: 245.4 – 313.7 people) and 2013/14 rate of 364.6 people (95% CI: 326.6 – 405.7) per 100,000 ESP 2013. However, in the most recent time period available (2014/15), the rate in NHS Crawley CCG (282.4 persons admitted per 100,000 ESP 2013, 95% CI: 249.7 – 318.1) was significantly lower compared to the previous year, indicating that data for 2013/14 may need to be explored further to identify reasons for the significant spike in admissions.
The number of people admitted to hospital for alcohol-specific conditions differs significantly among men and women, with men consistently having a higher rate of people admitted to hospital in all West Sussex CCGs, the South East region and in England in 2014/15 (see the chart below). In 2014/15, 180 men were admitted to hospital for an alcohol-specific condition in NHS Crawley CCG, at a rate of 367 people admitted per 100,000 ESP 2013 (95% CI: 313 – 427.5 people admitted). This is significantly higher than the female rate of admissions for NHS Crawley CCG in the same year (205.5 people admitted per 100,000 ESP 2013, 95% CI: 167.8 – 249 people, n= 110 people admitted).
In 2014/15, there were 577 admission episodes for alcohol-related conditions (narrow definition) in NHS Crawley CCG. This represented 593.5 admissions per 100,000 ESP 2013 (95% CI: 544.5 – 645.6 admissions per 100,000 ESP 2013). The NHS Crawley CCG admission episodes rate was similar to NHS Coastal West Sussex CCG (592.4 admissions per 100,000 ESP 2013, 95% CI: 571 – 614.5 admissions) and the England rate overall (640.8 admissions per 100,000 ESP 2013, 638.6 – 643 admissions), but it was significantly higher than NHS Horsham and Mid Sussex CCG (468.1 admissions per 100,000 ESP 2013, 95% CI: 440 – 497.5 admissions). The chart below shows the trend in alcohol related (narrow definition) admissions per 100,000 ESP 2013 for years 2010/11 to 2014/15. As can be seen from the chart, although the admissions rate has increased in NHS Crawley CCG between 2010/11 and 2013/14 before declining in 2014/15, the overlapping confidence intervals suggest that there may be no significant difference across years.
Hospital admissions episodes for alcohol related conditions (narrow definition) are also broken down by age. Click here to see alcohol-related hospital activity for those aged under 40, 40-64 years and 65+ years.