Publication of the Annual Northern Ireland Acute Episode-Based Activity Statistics for 2020/21

The Department of Health today published the Northern Ireland Acute Episode-Based Activity Statistics for 2020/21.

The purpose of this publication is to complement data contained in the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity (2020/21) publication, issued on 5 August 2021 and available on the DoH website.

While the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity (2020/21) 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 are comparable with the equivalent Hospital Episode Statistics published annually in England.

Key facts and figures for Northern Ireland Acute Episode-Based Activity Statistics for 2020/21

Number of finished consultant episodes within the acute programme of care

• In 2020/21, there were 496,628 such episodes, a decrease of 24.1 % on the previous year (654,478; (2019/20)) and similarly on the 654,626 recorded in 2016/17.
• A fifth (20.7%) of the 496,628 FCEs during 2020/21 were admitted for day case treatment (102,773). Since five years ago, the number of day case episodes has decreased 47.3 % from 194,855 in 2016/17 and there was also a decrease of 44.3% on the previous year’s figure of 184,384 in 2019/20. Over the same period, the number of inpatient episodes decreased also, but by much less, with a 13.7% decrease from 342,842 in 2016/17 to 295,764 in 2020/21. This also represented a decrease of 15.3% on the 2019/20 figure (349,389).
• The average length of an inpatient episode was 3.2 days in 2020/21, a decrease from the 3.4 days reported in both 2019/20 and 2016/17.

High Volume Activity

• In 2020/21, the most frequently recorded primary diagnosis was ‘chronic kidney disease’ (65,401 FCEs), representing 13.2% of all FCEs with ‘compensation for renal failure’ being the most frequently recorded main procedure (65,207).
• In 2020/21 there were 63,560 FCEs where a diagnosis of any cancer or neoplasm was recorded as the primary diagnosis – a decrease of 25.1% when compared to 2019/20 (84,816) and a decrease of 17.2% when compared to 2016/17 (76,773).

Topical Information Areas

• In 2020/21 there were 63,560 FCEs where a diagnosis of any cancer or neoplasm was recorded as the primary diagnosis – a decrease of 25.1% when compared to 2019/20 (84,816) and a decrease of 17.2% when compared to 2016/17 (76,773).
• From 2016/17 there has been a decrease of 47.9% in the number of FCEs where the primary diagnosis recorded was described as ‘influenza, pneumonia, etc.’, with 45,195 FCEs recorded then compared to 23,563 in 2020/21. This is also a decrease of 49.9% on the 46,989 FCEs recorded in 2019/20.
• FCEs where a diagnosis of ischaemic heart disease was recorded in a primary position in 2020/21 (11,254) have decreased by 21.1% from 14,262 recorded in 2016/17 and by 23.5% on the 14,704 recorded in 2019/20.
• There has been a fall in the number of FCEs where a hip procedure was the primary intervention, from 3,165 in 2016/17 and from 2,959 in 2019/20 to 1,538 in 2020/21, representing decreases of 51.4% and 48%, respectively.
• The number of cataract procedure FCEs has decreased to 2,784, representing a 55.6% decrease since last year (6,264; (2019/20)) and a decrease of 63.5% from 7,620 procedures in 2016/17.

Notes to editors: 

1. Allpublished 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 (2020/21) 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. HoPrior to this year, Independent Sector activity was included.

3. Definitions

• 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, DoH.  Further information is available from
   Hospital Information Branch
   Department of Health
   Annexe 2 Castle Buildings
   Stormont
   BT4 3SQ
   Telephone: 028 9052 2555
   Email: statistics@health-ni.gov.uk
   Internet: www.health-ni.gov.uk/articles/episode-based-activity

5. For media enquiries please contact DoH Press Office by email: pressoffice@health-ni.gov.uk. 

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7. The Executive Information Service operates an out of hours service For Media Enquiries Only between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The duty press officer can be contacted on 028 9037 8110.

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