Admission episodes for alcohol-specific conditions - WMCA

Admissions to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol-specific (wholly attributable) condition. Directly age standardised rate per 100,000 population (standardised to the European standard 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). ## Definition of numerator Admissions to hospital 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. ## 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 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. In order to allow comparison of groups with different age structures it is common to present “age standardised” rates. These are calculated by summing the product of age specific rates for each age band in the group by the number in that age band in the standard population. The sum is then divided by the total number in all age bands in the standard population to obtain the age standardised rate. This improves the comparability of rates for different areas, or between different time periods, by taking into account differences in the age structure of the populations being compared. Any difference between groups in age standardised rates is then not due to difference in age structure since the same standard population was used to calculate all age standardised rates. The method does however assume that minor differences in age structure within age bands are unimportant and in general this is true.