The Scottish Government

Title

Alcohol-related hospital admissions per 100,000 population.

National Indicator/Target

Reduce alcohol-related hospital admissions by 2011.

Brief Description

Rate of general hospital admissions where the diagnosis is related to alcohol, as defined by selected World Health Organisation's International Classification of Diseases 10 ^th revision ( ICD10) codes.

This is a measure of health harm caused by the misuse of alcohol.

Strategic Objective(s) to Which Indicator Relates

This indicator informs progress in relation to the Healthier and the Safer and Stronger Strategic Objectives.

More Detailed Definitions

Definitions of Keywords

The term admissions is used for clarity. The indicator measures the number of general acute inpatient and day case discharges per 100,000 population with an alcohol-related diagnosis.

The ICD10 codes used can be found in Appendix 3 of the Alcohol Statistics Scotland 2007 publication, which is available at

http://www.alcoholinformation.isdscotland.org/alcohol_misuse/files/Alcohol%20Bulletin.pdf

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.

The indicator excludes:

• admissions to mental illness hospitals, psychiatric units and maternity hospitals.
• transfer cases.
• patients resident outwith Scotland or those where NHS board or Local Authority 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).

The indicator was chosen to provide a measure of health harm caused by alcohol misuse. Tackling alcohol-related harm has been identified as one of the Scottish Government's key public health priorities.

Baseline and Past Trends

Baseline

The latest available alcohol-related admission rate suggests a standardised rate of admission of 749 per 100,000 for 2005/06.

The baseline for 2006/07 will be published in an ISD release on 18 ^th December 2007. However, the 2006/07 figure published in December will be based on around 96% of completed SMR01 returns and is therefore subject to further revisions.

While SMR01 data is continually revised and updated, around 99% of SMR01 returns are received within one year of the reporting period in question (the financial year for this indicator). The 2006/07 baseline will therefore be revised in May 2008 to provide a more accurate admission figure and allow for comparisons with previous years. In subsequent years, the admission rate will be based on the updated figures published in May of the following year. The 2010/11 alcohol-related admission rate will therefore be available in May 2012.

Trend

Steady increase in the rate of hospital admissions per 100,000 population over the last decade - from a standardised rate of 601 admissions per 100,000 in 1997/98 to 749 per 100,000 in 2005/6. There was a slight fall in the alcohol-related admission rate between 2004/05 and 2005/06 (from a rate of 754 to 749 per 100,000). Note: the 2005/06 figure is still considered provisional and may yet be subject to very slight revision.

Trend data is provided in the chart below:

Chart: Alcohol related hospital admissions per 100,000 population, Scotland 1997/98 to 2005/06

Source: Information Services Division Scotland (SMR01)

Methodology

The indicator reports episodes of care rather than the numbers of patients. Individual patients can receive multiple episodes of care within a single year.

The indicator reports general acute inpatient admissions 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.

To control for potential influences of changing population numbers and structures, the indicator reports a standardised population rate. The rate is calculated using the European Age Standardised Rate ( EASR) methodology. Age standardised rates facilitates comparisons across geographical areas by controlling for differences in the age structure of local populations.

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). The baseline for 2006-7 will be revised in May 2008.

Data Ownership and Quality Assurance

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

Publication of Data

Annual data published on

http://www.alcoholinformation.isdscotland.org

As noted above, baseline data is subject to revisions as there is no firm cut off for acceptance of returns. Revised figures will be produced in the following May (the exact date of data extraction will be agreed with ISD Scotland).