Publication of the Annual Northern Ireland Acute Episode-Based Activity Statistics for 2014/15

The Department of Health, Social Services and Public Safety today published the Northern Ireland acute episode-based activity statistics for 2014/15.

The purpose of this publication is to complement data contained in the Northern Ireland hospital statistics: inpatient and day case activity (2014/15) publication, issued on 6th August 2015 and available on the DHSSPS website.

While the Northern Ireland hospital statistics: inpatient and day case activity (2014/15) publication is based on admissions to hospitals, this publication is based on finished consultant episodes (FCEs). A patient may have more than one FCE during an admission to hospital.

The acute episode-based activity statistics show detailed analysis at specialty, diagnosis, procedure and healthcare resource group levels within the acute programme of care (PoC 1). Episode-based data in Northern Ireland can be compared with the equivalent hospital episode statistics published annually in England.

Key facts and figures

Number of finished consultant episodes within the acute programme of care

In 2014/15, there were 625,687 FCEs in Northern Ireland hospitals within the acute programme of care, an increase of 2.9% on the previous year (608,299 in 2013/14) and an increase of 10.4% on the 566,531 recorded in 2010/11.

Of the 625,687 FCEs during 2014/15, almost a third, 186,788 (29.9%) were admitted for day case treatment. Over the last five years, the number of day case episodes has increased by 7.1% from 174,391 in 2010/11 to 186,788 in 2014/15. Over the same period, the number of inpatient episodes increased by 15.9% from 281,378 in 2010/11 to 326,090 in 2014/15.

The average length of an inpatient episode was 3.5 days in 2014/15; a decrease from 4.5 days in 2010/11.

High Volume Activity

This activity relates to the most common procedures carried out in health and social care hospitals, and the most frequently recorded diagnosis of patients admitted to hospital.

Primary Diagnosis

In 2014/15, the five most commonly recorded primary diagnoses accounted for 22.3% (139,350) of all FCEs. The most frequently recorded was chronic kidney disease, with a total of 93,881 FCEs (15.0%); followed by pneumonia, organism unspecified; other disorders of urinary system; abdominal and pelvic pain; and other chronic obstructive pulmonary disease, each accounting for approximately 2% of the total number of FCEs.

Main Procedures / Interventions

In 2014/15, the five most frequent main procedures accounted for 24.8% (155,030) of FCEs. Compensation for renal failure was the most frequently recorded main procedure, with 93,380 (14.9%) FCEs, followed by: diagnostic fibreoptic endoscopic examination of upper gastrointestinal tract (3.9%); diagnostic imaging of central nervous system (2.2%); diagnostic imaging procedures (2.0%); and diagnostic endoscopic examination of colon (1.8%).

Topical Information Areas

These are the information areas most frequently requested by customers, including researchers and the general public.

Primary Diagnosis

In 2014/15 there were 70,396 FCEs where a diagnosis of cancer or other neoplasm was recorded as the primary diagnosis – an increase of 18.7% when compared to 2010/11 (59,309) and 8.1% when compared to 2013/14 (65,151).

Over the same period there has been an increase of 39.8% (increasing from 29,909 in 2010/11 to 41,803 in 2014/15) in the number of FCEs where the primary diagnosis recorded was influenza, pneumonia, etc.

FCEs where a diagnosis of ischaemic heart disease was recorded in a primary position, have increased by 4.0% from 14,440 recorded in 2010/11 to 15,014 recorded in 2014/15.

Main Procedures/Interventions

There has been an increase in the number of FCEs where a hip procedure was the primary intervention, from 2,786 in 2010/11 to 2,979 in 2014/15 – an increase of 6.9%.

The number of FCEs where a cataract procedure was carried out has increased over the five year period from 7,735 in 2010/11 to 8,307 in 2014/15, representing an increase of 7.4%.

Notes to editors: 

1. All published hospital inpatient activity data is available online
2. About the data

• A consultant episode is the time a patient spends in the continuous care of one consultant. The episode can be finished because of discharge, death or transfer, either to another consultant or another hospital. As a result, a patient may have more than one FCE during an admission to hospital (if transferred to the care of another consultant).
• Episode based data is used to perform detailed analysis at diagnostic and procedure level, which may vary between each of the episodes that form an admission. Episode data is used to answer Assembly /Parliamentary questions, ad-hoc queries and for financial analysis. In addition, episode based data in Northern Ireland can be compared with the equivalent Hospital Episode Statistics data published annually in England.
• Inpatient and day case episode data for all specialties within the acute services programme of care is collated monthly from each hospital’s Patient Administration System and is recorded in the Hospital Inpatient System (HIS). Each record within the HIS relates to an individual consultant episode and records details such as the date the patient was admitted the diagnosis of the patient and any interventions/procedures the patient underwent.
• The total number of bed days has been calculated using the episode duration field within the Hospital Inpatient System; this is in contrast to the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity (2014/15) publication which uses specialty level bed occupancy data from the KH03a aggregate return.
• All data published from 2008/09 excludes Independent Sector activity carried out within HSC Hospitals. Prior to this year, Independent Sector activity was included.Definitions

3. Admission: Total admissions has been taken to be the sum of all day cases, inpatients (elective and non elective) and regular attenders. Deaths and discharges have been used as an approximation for admissions.

• Day Case: A patient admitted electively during the course of a day with the intention of receiving care, who does not require the use of a hospital bed overnight and who returns home as scheduled. If this original intention is not fulfilled and the patient stays overnight, such a patient should be counted as an inpatient.
• Elective Inpatient: A patient for whom the decision to admit could be separated in time from the actual admission. This excludes emergency admissions and maternity or delivery episodes.
• Finished Consultant Episode (FCE): A period of continuous admitted patient treatment under the care of a consultant. An episode may be finished through death, discharge or transfer to the care of another consultant or hospital. If the patient is transferred from one consultant to another, a new FCE commences.
• Primary Diagnosis: The condition established as the main reason for admission after all investigations, diagnostic examinations and procedures have been carried out.
• Procedure/Intervention: A procedure or series of procedures aimed at restoring or improving the health of a patient, as by correcting a malformation, removing diseased parts, implanting new parts, etc. Defined by an OPCS code recorded in any of the procedure fields in the Hospital Inpatient System excluding codes Y80, Y81, Y82, Y84, Y90 and all Z codes.
• Bed Days: A day of bed occupation by an admitted inpatient (beds used for day case admissions and regular day / night attenders are not included). For example, if there are 100 inpatients who each remain in hospital for 5 days, the bed days figure will be 500. The total number of bed days in Acute Episode-Based Activity Statistics has been calculated using the episode duration field within the Hospital Inpatient System; this is in contrast to the Inpatient and Day Case Activity Statistics publication which uses specialty-level bed occupancy data from the KH03a aggregate return.

4. This information was collated by Hospital Information Branch. Further information is available from Hospital Information Branch

5.Media queries to DHSSPS Press Office on 02890 520074, or out of office hours contact the Duty Press Officer via pager number 076 9971 5440 and your call will be returned. Follow us on Twitter @healthdpt

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