Long Terms
Conditions Analysis
Admissions, prevalence and comparisons
Sarah Lawton
11
Information in this report shows the following





Emergency Admissions
Length of stay and average length of stay
Death rate per 100,000
Prevalence maps
National comparators information showing PCT and practice level
benchmarking
COPD PREVALENCE .......................................................................................................................... 2
COPD MORTALITY ............................................................................................................................. 3
COPD EMERGENCY ADMISSIONS ................................................................................................. 3
COPD EMERGENCY ADMISSIONS – NATIONAL AND LOCAL COMPARISONS ................ 4
DIABETES PREVALENCE ................................................................................................................. 6
DIABETES MORTALITY .................................................................................................................... 7
DIABETES EMERGENCY ADMISSIONS ........................................................................................ 7
DIABETES EMERGENCY ADMISSIONS- NATIONAL AND LOCAL COMPARISONS ......... 9
ASTHMA PREVALENCE .................................................................................................................. 10
ASTHMA MORTALITY .................................................................................................................... 11
ASTHMA MORTALITY – CHILDREN (AGED UNDER 18) ........................................................ 11
ASTHMA EMERGENCY ADMISSIONS (ALL AGES) ................................................................. 11
ASTHMA EMERGENCY ADMISSIONS (CHILDREN AGED UNDER 18) ............................... 13
ASTHMA EMERGENCY ADMISSIONS (CHILDREN AGED 16 AND UNDER) ...................... 14
ASTHMA EMERGENCY ADMISSIONS (ALL AGES) -NATIONAL AND LOCAL
COMPARISONS .................................................................................................................................. 15
CHD PREVALENCE ........................................................................................................................... 17
CHD MORTALITY ............................................................................................................................. 18
CHD EMERGENCY ADMISSIONS .................................................................................................. 18
CHD EMERGENCY ADMISSIONS- NATIONAL AND LOCAL COMPARISONS................... 20
STROKE PREVALENCE ................................................................................................................... 21
STROKE MORTALITY ..................................................................................................................... 22
ALL AGES ............................................................................................................................................ 22
STROKE EMERGENCY ADMISSIONS .......................................................................................... 22
CVD PREVALENCE ........................................................................................................................... 24
CVD MORTALITY ............................................................................................................................. 24
CVD EMERGENCY ADMISSIONS AGED UNDER 75 ................................................................. 24
1
COPD Prevalence
QOF figures as at quarter 2 for 2010/11 show 8,929 people are recorded with
COPD, 2009/10 showed 8,805 people were recorded with COPD at year end.
4 out of 41 practices have not made a submission as at 31st September 2010.
These 4 practices have had there March 2009 position rolled forward.
The map below gives estimated rates of COPD in Wakefield based on
2009/10 QOF data.
Figure 1 - COPD Prevalence Map
2
COPD Mortality – Directly Standardised Rates per 100,000 population
Year
2005
2006
2007
2008
2009
2010
Number
164
166
217
210
173
185
DSR
32.86 (NCHOD)
31.37 (NCHOD)
41.16 (NCHOD)
40.08 (NCHOD)
32.50 (NCHOD)
34.6*
95% lower CI
29.6
95% upper CI
40.1
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
COPD Deaths DSR Rate
45
40
41.22
40.16
DSR Rate
35
30
32.89
32.48
31.41
34.6
25
20
15
10
5
0
2005
2006
2007
2008
2009
2010
Year
Figure 2 - COPD Death DSR Rate
COPD Emergency Admissions
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
1277
11798
9.2
6
2003/04
1326
11877
9.0
6
2004/05
1289
10077
7.8
5
2005/06
1174
8847
7.5
5
2006/07
1116
8617
7.7
5
2007/08
1127
8545
7.6
5
2008/09
1155
8019
6.9
4
2009/10
1125
7814
6.9
4
2010/11
1235
7795
6.3
4
3
COPD Emergency Admissions
1500
Total Admissions
1300
1100
1277
1326
1235
1289
1174
1116
1127
1155
2006/07
2007/08
2008/09
1125
900
700
500
300
100
2002/03
2003/04
2004/05
2005/06
2009/10
2010/11
Year
Figure 3 - COPD Emergency Admission
Emergency Bed Days
COPD Emergency Bed Days
Mean Los
Median Los
10
14000
9
8
Volume
7
12000
11798
11877
10000
10077
6
8847
8617
5
8545
8019
8000
7814
7795
4
6000
3
4000
2
2000
1
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
Year
Figure 4 - COPD Emergency Bed Days
COPD Emergency Admissions – National and Local Comparisons
4
2009/10
2010/11
Type
Org
PCT
SHA
National
Total
Count
1045
Expected
Count
655
Count Diff
% Diff
5N3
Standardised
Rate
2.9
390
59.5
Q32
2.3
12810
10174
2636
25.9
1.8
101068
101068
0
0
Figure 5 - 2009/10 – National Comparators
Figure 6 - National Comparators - Benchmarking Practices
5
Diabetes Prevalence
QOF figures as at quarter 2 for 2010/11 show 16,592 people are recorded
with Diabetes, 2009/10 showed 16,150 people were recorded with Diabetes at
year end.
4 out of 41 practices have not made a submission as at 31st September 2010.
These 4 practices have had there March 2009 position rolled forward.
The map below gives estimated rates of Diabetes in Wakefield based on
2009/10 QOF data.
Figure 7 - Diabetes Prevalence Map
6
Diabetes Mortality – Directly Standardised Rates per 100,000 population
All Ages
Year
2005
2006
2007
2008
2009
2010
Number
36
24
25
30
29
20
DSR
6.04 (NCHOD)
4.57 (NCHOD)
4.71 (NCHOD)
5.71 (NCHOD)
5.13 (NCHOD)
3.9*
95% lower CI
2.2
95% upper CI
6.1
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
DSR Rate
Diabetes Deaths DSR Rate
9
8
7
6
5
4
3
2
1
0
7.87
5.72
4.57
5.14
4.72
3.9
2005
2006
2007
2008
2009
2010
Year
Figure 8 - Diabetes Death DSR Rate
Diabetes Emergency Admissions
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
218
1477
6.8
4
2003/04
224
1855
8.2
3
2004/05
224
1774
7.9
3
2005/06
218
1117
5.1
3
2006/07
255
1296
5.1
3
2007/08
263
1784
6.8
2
2008/09
236
1228
5.2
2
2009/10
240
1229
5.1
2
2010/11
264
1228
4.7
2
7
Diabetes Emergency Admissions
300
250
Total Admissions
255
200
218
224
224
264
263
218
236
240
2008/09
2009/10
150
100
50
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2010/11
Year
Figure 9 - Diabetic Emergency Admissions
Emergency Bed Days
Diabetes Emergency Bed Days
Mean Los
Median Los
9
Volume
8
7
6
1855
1774
1477
1784
5
4
1117
1296
2005/06
2006/07
1228
1229
1228
2008/09
2009/10
2010/11
3
2
1
0
2002/03
2003/04
2004/05
2007/08
Year
Figure 10 - Diabetic Emergency Bed Days
8
2000
1800
1600
1400
1200
1000
800
600
400
200
0
Diabetes Emergency Admissions- National and Local Comparisons
Type
Org
PCT
SHA
National
Total
Count
224
Expected
Count
239
Count Diff
% Diff
5N3
Standardised
Rate
0.6
-15
-6.3
Q32
0.7
3646
3740
-94
-2.5
0.7
37325
37325
0
0
Figure 11 - 2009/10 – National Comparators
Figure 12 - National Comparators - Benchmarking Practices on Diabetes
9
Asthma Prevalence
QOF figures as at quarter 2 for 2010/11 show 23,833 people are recorded
with Asthma, 2009/10 showed 23,608 people were recorded with Asthma at
year end.
4 out of 41 practices have not made a submission as at 31st September 2010.
These 4 practices have had there March 2009 position rolled forward.
The map below gives estimated rates of Asthma in Wakefield based on
2009/10 QOF data.
Figure 13 - Asthma Prevalence Map
10
Asthma Mortality – Directly Standardised Rates per 100,000 population
All Ages
Year
2005
2006
2007
2008
2009
2010
Number
12
10
7
11
8
9
DSR
2.93 (NCHOD)
2.30 (NCHOD)
1.95 (NCHOD)
2.35 (NCHOD)
1.61 (NCHOD)
1.7*
95% lower CI
0.7
95% upper CI
3.4
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
Asthma Deaths DSR Rate
3.5
3
DSR Rate
2.5
2.94
2.35
2.3
2
1.95
1.5
1.7
1
1.16
0.5
0
2005
2006
2007
2008
2009
2010
Year
Figure 14 – Asthma Death DSR Rate
Asthma Mortality – Children (aged under 18)
There were no deaths in Wakefield from Asthma for children aged under 18
between 2005 and 2010
Asthma Emergency Admissions (all ages)
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
539
1555
2.9
1
2003/04
536
1631
3.0
2
2004/05
603
1865
3.1
1
2005/06
560
2110
3.8
2
2006/07
507
1703
3.4
2
2007/08
462
1568
3.4
2
2008/09
576
2087
3.6
2
2009/10
590
2050
3.4
2
2010/11
580
2160
3.7
2
11
Asthma Emergency Admissions
700
Total Admissions
600
500
603
539
536
580
576
590
2008/09
2009/10
560
507
400
462
300
200
100
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2010/11
Year
Figure 15 - Asthma Emergency Admissions- All Ages
Emergency Bed Days
Asthma Emergency Bed Days
Mean Los
Median Los
4
2500
Volume
3.5
2087
1865
2.5
2
2160
2110
3
1555
1703
1631
2000
2050
1500
1568
1000
1.5
1
500
0.5
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
Year
Figure 16 - Asthma Emergency Bed Days – All Ages
12
2008/09
2009/10
2010/11
Asthma Emergency Admissions (children aged under 18)
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
236
240
1.0
1
2003/04
230
288
1.3
1
2004/05
272
317
1.2
1
2005/06
221
236
1.1
1
2006/07
214
261
1.2
1
2007/08
179
199
1.1
1
2008/09
225
233
1.0
1
2009/10
219
267
1.2
1
2010/11
183
201
1.1
1
Asthma Emergency Admissions
Children under 18 years of age
Total Admissions
300
250
200
272
236
221
230
225
214
219
183
179
150
100
50
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
Year
Figure 17 - Asthma Emergency Admissions Under <18 Years
13
2009/10
2010/11
Volume
Asthma Emergency Bed Days
Children under 18 years of age
Emergency Bed Days
Mean Los
Median Los
1.4
350
1.2
300
1
250
0.8
288
317
261
0.6
200
267
233
236
240
201
150
199
0.4
100
0.2
50
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
2009/10
2010/11
Year
Figure 18 - Asthma Emergency Bed Days Under <18 Years
Asthma Emergency Admissions (children aged 16 and under)
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
229
226
0.98
1
2003/04
227
282
1.24
1
2004/05
270
309
1.14
1
2005/06
212
209
0.98
1
2006/07
204
239
1.17
1
2007/08
177
193
1.09
1
2008/09
222
211
0.95
1
2009/10
214
241
1.12
1
2010/11
177
182
1.0
1
Asthma Emergency Admissions
Children 16 years and under
300
Total Admissions
250
270
200
229
227
212
222
204
150
214
177
177
100
50
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
Figure 19 - Asthma Emergency Admissions 16 years and under
14
2009/10
2010/11
Asthma Emergency Bed Days
Children 16 years and under
Mean Los
Median Los
1.4
350
1.2
300
1
Volume
Emergency Bed Days
0.8
282
250
309
226
239
209
0.6
200
241
193
211
182
150
0.4
100
0.2
50
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
2009/10
2010/11
Year
Figure 20 - Asthma Emergency Bed Days 16 years and under
Asthma Emergency Admissions (all ages) -National and Local Comparisons
15
Type
Org
PCT
SHA
National
Total
Count
547
Expected
Count
384
Count Diff
% Diff
5N3
Standardised
Rate
1.6
163
42.4
Q32
1.1
6214
6006
208
3.5
1.1
60456
60456
0
0
Figure 21 - 2009/10 – National Comparators
Figure 22 -National Comparators - Benchmarking Practices on Asthma All Ages
16
CHD Prevalence
QOF figures as at quarter 2 for 2010/11 show 15931 people are recorded with
CHD, 2009/10 showed 15,917 people were recorded with CHD at year end.
4 out of 41 practices have not made a submission as at 31st September 2010.
These 4 practices have had there March 2009 position rolled forward.
The map below gives estimated rates of CHD in Wakefield based on 2009/10
QOF data.
Figure 23 - CHD Prevalence Map
17
CHD Mortality – Directly Standardised Rates per 100,000 population
All Ages
Year
2005
2006
2007
2008
2009
2010
Number
595
511
478
536
456
484
DSR
124.39 (NCHOD)
103.46 (NCHOD)
92.25 (NCHOD)
105.11 (NCHOD)
86.69 (NCHOD)
95.1*
95% lower CI
86.4
95% upper CI
104.4
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
CHD Deaths DSR Rate
140
120
124.52
DSR Rate
100
105.35
103.62
92.42
80
86.64
95.1
60
40
20
0
2005
2006
2007
2008
2009
2010
Year
Figure 24 - CHD Death DSR Rate
CHD Emergency Admissions
Year
Total admissions
Total bed days
Mean Los
Median Los
2002/03
1755
12513
7.1
5
2003/04
1883
14520
7.7
5
2004/05
1610
12940
8.0
5
2005/06
1464
11636
7.9
6
2006/07
1392
10484
7.5
6
2007/08
1258
10116
8.0
5
2008/09
1184
8230
7.0
5
2009/10
1132
8239
7.2
5
2010/11
1026
6243
6.1
4
18
Total Admissions
CHD Emergency Admissions
2100
1900
1700
1500
1300
1100
900
700
500
300
100
1883
1755
1610
1464
1392
1258
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
1184
2008/09
1132
1026
2009/10
2010/11
Year
Figure 25 - CHD Emergency Admissions
Emergency Bed Days
CHD Emergency Bed Days
Mean Los
Median Los
9
16000
8
14000
Volume
7
6
12513
14520
12000
12940
11636
5
10000
10484
10116
4
8000
8230
8239
3
6243
6000
2
4000
1
2000
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
Year
2007/08
Figure 26 - CHD Emergency Bed Days
19
2008/09
2009/10
2010/11
CHD Emergency Admissions- National and Local Comparisons
Type
Org
PCT
SHA
National
Total
Count
1028
Expected
Count
878
Count Diff
% Diff
5N3
Standardised
Rate
2.9
150
17.1
Q32
2.8
15336
13558
1778
13.1
2.5
135178
135178
0
0
Figure 27 - 2009/10 – National Comparators
Figure 28 - National Comparators - Benchmarking Practices on CHD All Ages
20
Stroke Prevalence
QOF figures as at quarter 2 for 2010/11 show 7,431 people are recorded as
having a Stroke, 2009/10 showed 7,321 people were recorded as having a
Stroke.
4 out of 41 practices have not made a submission as at 31st September 2010.
These 4 practices have had there March 2009 position rolled forward.
The map below gives estimated rates of Stroke in Wakefield based on
2009/10 QOF data.
Figure 29 - Stroke Prevalence Map
21
Stroke Mortality – Directly Standardised Rates per 100,000 population
All Ages
Year
2005
2006
2007
2008
2009
2010
Number
317
308
281
290
239
231
DSR
60.19 (NCHOD)
56.98 (NCHOD)
51.17 (NCHOD)
51.60 (NCHOD)
42.05 (NCHOD)
40.2*
95% lower CI
35
95% upper CI
46
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
Stroke Deaths DSR Rate
70
60
DSR Rate
60.23
50
57.03
51.69
51.24
40
42.03
40.2
2009
2010
30
20
10
0
2005
2006
2007
2008
Year
Figure 30 - Stroke Death DSR Rate
Stroke Emergency Admissions
Year
Total admissions
Total bed days
2002/03
574
22272
38.8
14
2003/04
617
18890
30.6
13
2004/05
581
17845
30.7
12
2005/06
524
15590
29.7
12
2006/07
498
13012
26.1
10
2007/08
505
11761
23.3
9
2008/09
420
7404
17.6
8
2009/10
434
7466
17.2
9
2010/11
530
8548
16.1
8
22
Mean Los
Median Los
Stroke Emergency Admissions
700
Total Admissions
600
500
574
617
581
524
530
498
505
400
420
434
2008/09
2009/10
300
200
100
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2010/11
Year
Figure 31 - Stroke Emergency Admissions
Stroke Emergency Bed Days
Emergency Bed Days
Mean Los
Median Los
45
25000
40
Volume
35
20000
22272
30
18890
25
17845
15000
15590
13012
20
11761
15
10000
7404
10
7466
8548
5000
5
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
Year
2007/08
Figure 32 - Stroke Emergency Bed Days
23
2008/09
2009/10
2010/11
CVD Prevalence
CVD Mortality <75 Years– Directly Standardised Rates per 100,000 population
Year
2005
2006
2007
2008
2009
2010
Number
379
323
303
359
284
311
DSR
106.22 (NCHOD)
90.37 (NCHOD)
82.76 (NCHOD)
97.64 (NCHOD)
75.53 (NCHOD)
85.1*
95% lower CI
75.7
95% upper CI
95.3
*Mortality Rates for 2010 could change
 Locally calculated figures
 Mid Year Estimates 2009 used as mid 2010 population estimates unavailable
CVD Deaths <75 Years DSR Rate
120
DSR Rate
100
106.41
98
90.6
80
85.1
83.05
72.45
60
40
20
0
2005
2006
2007
2008
2009
2010
Year
Figure 33 - CVD Death DSR Rate
CVD Emergency Admissions aged under 75
Year
Total admissions
Total bed days Mean Los
Median Los
2002/03
2539
25667
10.1
5
2003/04
2644
25424
9.6
5
2004/05
2412
22629
9.4
5
2005/06
2289
19980
8.7
4
2006/07
2261
17769
7.9
4
2007/08
2182
17669
8.1
4
2008/09
2054
14574
7.1
3
2009/10
2215
15240
6.8
3
2010/11
2116
13179
6.2
3
24
CVD Emergency Admissions
3100
Total Admissions
2600
2100
2644
2539
2289
2412
2261
2182
1600
2054
2215
2116
2008/09
2009/10
2010/11
1100
600
100
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
Year
Figure 34 - CVD Emergency Admissions
CVD Emergency Bed Days
Emergency Bed Days
Mean Los
Median Los
12
30000
10
25000
25667
25424
Volume
8
20000
22629
19980
17769
6
17669
14574
15000
15240
13179
4
2
10000
5000
0
0
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
Year
Figure 35 – CVD Emergency Bed Days
List of Figures
25
2008/09
2009/10
2010/11
FIGURE 1 - COPD PREVALENCE MAP......................................................................................................... 2
FIGURE 2 - COPD DEATH DSR RATE ......................................................................................................... 3
FIGURE 3 - COPD EMERGENCY ADMISSION................................................................................................ 4
FIGURE 4 - COPD EMERGENCY BED DAYS ................................................................................................. 4
FIGURE 5 - 2009/10 Q1, Q2 ROLLING YEAR – NATIONAL COMPARATORS ..................................................... 5
FIGURE 6 - NATIONAL COMPARATORS - BENCHMARKING PRACTICES ........................................................... 5
FIGURE 7 - DIABETES PREVALENCE MAP .................................................................................................... 6
FIGURE 8 - DIABETES DEATH DSR RATE..................................................................................................... 7
FIGURE 9 - DIABETIC EMERGENCY ADMISSIONS .......................................................................................... 8
FIGURE 10 - DIABETIC EMERGENCY BED DAYS ........................................................................................... 8
FIGURE 11 - 2009/10 Q1, Q2 ROLLING YEAR – NATIONAL COMPARATORS ................................................... 9
FIGURE 12 - NATIONAL COMPARATORS - BENCHMARKING PRACTICES ON DIABETES .................................... 9
FIGURE 13 - ASTHMA PREVALENCE MAP ................................................................................................... 10
FIGURE 14 – ASTHMA DEATH DSR RATE .................................................................................................. 11
FIGURE 15 - ASTHMA EMERGENCY ADMISSIONS- ALL AGES ....................................................................... 12
FIGURE 16 - ASTHMA EMERGENCY BED DAYS – ALL AGES......................................................................... 12
FIGURE 17 - ASTHMA EMERGENCY ADMISSIONS UNDER <18 YEARS .......................................................... 13
FIGURE 18 - ASTHMA EMERGENCY BED DAYS UNDER <18 YEARS ............................................................. 14
FIGURE 17 - ASTHMA EMERGENCY ADMISSIONS 16 YEARS AND UNDER ....................................................... 14
FIGURE 18 - ASTHMA EMERGENCY BED DAYS 16 YEARS AND UNDER .......................................................... 15
FIGURE 19 - 2009/10 Q1, Q2 ROLLING YEAR – NATIONAL COMPARATORS ................................................. 16
FIGURE 20 -NATIONAL COMPARATORS - BENCHMARKING PRACTICES ON ASTHMA ALL AGES ...................... 16
FIGURE 21 - CHD PREVALENCE MAP ....................................................................................................... 17
FIGURE 22 - CHD DEATH DSR RATE ....................................................................................................... 18
FIGURE 23 - CHD EMERGENCY ADMISSIONS ............................................................................................ 19
FIGURE 24 - CHD EMERGENCY BED DAYS ............................................................................................... 19
FIGURE 25 - 2009/10 Q1, Q2 ROLLING YEAR – NATIONAL COMPARATORS ................................................. 20
FIGURE 26 - NATIONAL COMPARATORS - BENCHMARKING PRACTICES ON CHD ALL AGES ......................... 20
FIGURE 27 - STROKE PREVALENCE MAP ................................................................................................... 21
FIGURE 28 - STROKE DEATH DSR RATE.................................................................................................... 22
FIGURE 29 - STROKE EMERGENCY ADMISSIONS ......................................................................................... 23
FIGURE 30 - STROKE EMERGENCY BED DAYS ............................................................................................ 23
FIGURE 31 - CVD DEATH DSR RATE ........................................................................................................ 24
FIGURE 32 - CVD EMERGENCY ADMISSIONS ............................................................................................. 25
FIGURE 33 – CVD EMERGENCY BED DAYS ............................................................................................... 25
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Data sources and Disease Codes
Data Sources:
Emergency Bed Days: SUS (CQC definition query)
Emergency Admissions: SUS (Emergency Admissions query)
Deaths: ONS
Prevalence: QMAS
PCT and Practice Benchmarking: National Comparators
Disease Codes: (NCHOD Definition)
Diabetes: E100 – E149
COPD: J400 – J449
Asthma: J450 – J46
Stroke: I61, I62, I63, I64 (Emergency Admissions), I60 – I69 (Stroke Mortality)
CHD: I200 – I259
CVD <75 years I00X – I99X
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