Admission episodes for alcohol-specific conditions - Under 18s - WMCA

Admissions to hospital for under 18s where the primary diagnosis or any of the secondary diagnoses are an alcohol-specific (wholly attributable) condition. Crude rate per 100,000 population. ## Rationale Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually. The Government has said that everyone has a role to play in reducing the harmful use of alcohol - this indicator is one of the key contributions by the Government (and the Department of Health) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related admissions can be reduced through local interventions to reduce alcohol misuse and harm. Reducing alcohol-related harm is one of Public Health England’s seven priorities for the next five years (from the “Evidence into action” report 2014). The Sexual Health Framework (2013) highlights the following: * There is an association between alcohol-attributable hospital admissions in both males and females with teenage pregnancy, even after controlling for the overriding and strong effect of deprivation, and the same is true for the more common sexually transmitted infections. * There is evidence that alcohol consumption and being drunk can result in lower inhibitions and poor judgements regarding sexual activity, vulnerability, and risky sexual behaviour, such as not using contraception or condoms. * Alcohol consumption by young people leads to an increased likelihood that they will have sex at a younger age, and alcohol misuse is linked to a greater number of sexual partners and more regretted or coerced sex. * Alcohol also increases the risk of sexual aggression, sexual violence, and sexual victimisation of women. ## Definition of numerator The number of hospital admission episodes for under 18s where the primary diagnosis or any of the secondary diagnoses are an alcohol-specific (wholly attributable) condition code only. More specifically, hospital admissions records are identified where: * The admission is a finished episode [epistat = 3]; * The admission is an ordinary admission, day case, or maternity [classpat = 1, 2, or 5]; * It is an admission episode [epiorder = 1]; * The sex of the patient is valid [sex = 1 or 2]; * There is a valid age at start of episode [startage between 0 and 150 or between 7001 and 7007]; * The region of residence is one of the English regions, no fixed abode, or unknown [resgor <= K or U or Y]; * The episode end date [epiend] falls within the financial year; * A wholly alcohol-attributable ICD10 code appears in any diagnosis field [diag_nn]. ## Definition of denominator ONS mid-year population estimates for 0-17 year olds. Three years are pooled. ## Caveats In 2023, NHS England announced a [requirement] for Trusts to report Same Day Emergency Care (SDEC) to the Emergency Care Data Set (ECDS) by July 2024. Early adopter sites began to report SDEC to ECDS from 2021/22, with other Trusts changing their reporting in 2022/23 or 2023/24. Some Trusts had previously reported this activity as part of the Admitted Patient Care data set, and moving to report to ECDS may reduce the number of admissions reported for this/these indicator/s. NHSE have advised it is not possible accurately to identify SDEC in current data flows, but the impact of the change is expected to vary by diagnosis, with indicators related to injuries and external causes potentially most affected. When considering if SDEC recording practice has reduced the number of admissions reported for this indicator at local level, please refer to the [list of sites] who have reported when they began to report SDEC to ECDS. Hospital admission data can be coded differently in different parts of the country. 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 local authority or PHE centre figures. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator. Does not include attendance at Accident and Emergency departments.