Activity in Acute Public Hospitals in Ireland ANNUAL REPORT 201
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Activity in Acute Public Hospitals in Ireland ANNUAL REPORT 201 Health Research and Information Division December 2013 2 METADATA Title Activity in Acute Public Hospitals in Ireland Annual Report, 2012 Creator Health Research and Information Division (HRID), The Economic and Social Research Institute (ESRI) Subject Key words – free text: Hospital discharge activity, acute hospital, public hospital Summary Description This is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2012. Discharge activity is examined by type of patient and hospital, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. Maternity discharges are examined separately from other discharges. The analysis is presented at the national level and is also disaggregated by Health Service Executive (HSE) administrative areas. Publisher Economic and Social Research Institute Contributors Health Research and Information Division, Economic and Social Research Institute, Health Service Executive, and the Department of Health Date First published December 2013 Type Report Identifier ISBN Language en – English Coverage National, HSE administrative areas Rights Downloadable from www.esri.ie Version 1.0 (December 2013) File 2012_AsOf_0913_V20_CLOSE_ANN Please note that there is the potential for minor revisions to the data set analysed in this report. Please check online at www.esri.ie for information on updates. ACKNOWLEDGEMENTS The production of this annual report requires commitment and hard work from many individuals. Responsibility for collecting, coding, inputting, and validating data for the Hospital In-Patient Enquiry (HIPE) scheme rests with colleagues in acute hospitals throughout Ireland. Ensuring the continued operation of the HIPE scheme requires willing contributions from clinicians, clinical coders, HIPE/casemix coordinators, medical records staff, IT personnel, and administrative departments, together with hospital managers. We are greatly indebted to these individuals for their support and efforts. The Department of Health and the Health Service Executive are acknowledged for the financial support allocated to the HIPE scheme and for the substantial input to the development of HIPE. In particular, we would like to express our gratitude to Fiachra Bane, Alan Cahill, Lorna Collins, Gráinne Cosgrove, Emer Gallagher, and Cliona O’Donovan for their comments on an early draft of this report. We would also like to thank Prof. Michael Turner (University College Dublin) for helpful comments on an early draft of the Maternity Section of this report. The HIPE team within the Economic and Social Research Institute's Health Research and Information Division oversees a wide range of tasks related to the management of this system, including software development and support, personnel training, data quality and audit, data management and analysis, and information dissemination. We acknowledge gratefully the dedication, skill and expertise that all the members of this team bring to their work on this scheme. We would also like to thank, specifically, Jacqui Curley, Brian McCarthy, and Deirdre Murphy for reviewing and commenting on earlier drafts of this report, and Edgar Morgenroth for advising on the population data. Inevitably, a number of individuals have to carry most of the responsibility for producing a report of this type. In this case Sheelagh Bonham, Aoife Brick, Nathan Cunningham, Karen Kearns, Shane Leavy, Léan McMahon, Laura Metcalfe, Aisling Mulligan and Sinéad O'Hara were to the fore in the preparation of the report for publication. We wish to express our sincere thanks to these colleagues for all of their hard work on the report. Their commitment, enthusiasm, and professionalism are gratefully acknowledged and sincerely appreciated. Table of Contents | i Table of Contents LIST OF TABLES ___________________________________________________________________ ii LIST OF FIGURES __________________________________________________________________ iv EXECUTIVE SUMMARY _____________________________________________________________ v SECTION ONE Overview ________________________________________________________________________ 1 1.1 Introduction __________________________________________________________________________ 3 1.2 Background __________________________________________________________________________ 3 1.3 Data Sources for Annual Report 2012______________________________________________________ 4 1.4 Structure of Annual Report 2012 _________________________________________________________ 4 1.5 Scope of HIPE Data ____________________________________________________________________ 6 1.6 Methods and Definitions ________________________________________________________________ 7 1.7 Discharges Reported to HIPE, 2008 – 2012 _________________________________________________ 8 SECTION TWO Discharge Overview 2012__________________________________________________________ 13 2.1 Introduction _________________________________________________________________________ 15 2.2 Who _______________________________________________________________________________ 16 2.3 Where______________________________________________________________________________ 29 2.4 When ______________________________________________________________________________ 54 SECTION THREE Morbidity Analysis 2012 __________________________________________________________ 59 3.1 Introduction _________________________________________________________________________ 61 3.2 Coding of Diagnoses and Procedures _____________________________________________________ 62 3.3 Morbidity Analysis: Summary of Day Patient and In-Patient Activity ____________________________ 68 3.4 Morbidity Analysis: Total Discharge Activity (excl. Maternity) _________________________________ 76 SECTION FOUR Maternity Discharges 2012 ________________________________________________________ 93 4.1 Introduction _________________________________________________________________________ 95 4.2 Maternity Discharges – Total ___________________________________________________________ 96 4.3 Maternity Discharges – Delivery _________________________________________________________ 99 4.4 Maternity Discharges – Non-Deliveries __________________________________________________ 114 SECTION FIVE Case Mix Analysis 2012 __________________________________________________________ 117 5.1 Introduction ________________________________________________________________________ 119 5. 2 Analysis of HIPE Data by Case Mix ______________________________________________________ 122 ANNEX ________________________________________________________________________ 163 Diabetes Discharge Profile, 2012 _____________________________________________________________ 165 GLOSSARY AND ABBREVIATIONS _________________________________________________________ 171 APPENDICES ___________________________________________________________________ 179 Appendix I: HIPE Hospitals __________________________________________________________________ 181 Appendix II: HIPE Data Collected _____________________________________________________________ 183 Appendix III: HIPE Data Entry Form ___________________________________________________________ 185 Appendix IV: Bed Data _____________________________________________________________________ 186 Appendix V: Population Estimates, 2012 _______________________________________________________ 188 Appendix VI: Derived Variables ______________________________________________________________ 189 Appendix VII: Reference Tables ______________________________________________________________ 190 Appendix VIII: Australian Coding Standard 0042 _________________________________________________ 191 ii | Activity in Acute Public Hospitals 2012 List of Tables TABLE 1.1 Acute Public Hospital Discharges in HIPE (N,%), 2008 – 2012 _____________________________________ 9 TABLE 2.1a Total Discharges (excl. Maternity): Patient Type by Age Group (N, % Bed Days, % and In-Patient Length of Stay) _________________________________________________________________________________ 17 TABLE 2.1b Total Male Discharges: Patient Type by Age Group (N, %, Bed Days, % and In-Patient Length of Stay) ____ 19 TABLE 2.1c Total Female Discharges (excl. Maternity): Patient Type by Age Group (N, %, Bed Days, % and In-Patient Length of Stay) _________________________________________________________________________ 20 TABLE 2.2 Total Discharges (excl. Maternity): Patient Type by Marital/Civil Status (N, %) _______________________ 23 TABLE 2.3 Total Discharges (excl. Maternity): Public/Private Status by Age Group (N, %) _______________________ 25 TABLE 2.4 Total Discharges (excl. Maternity): GMS Status by Age Group (N, %) ______________________________ 26 TABLE 2.5 Total Discharges (excl. Maternity): Public/Private Status by GMS Status and Patient Type (N, %) ________ 28 TABLE 2.6 Total Discharges (excl. Maternity): HSE Area of Hospitalisation by Patient Type and Admission Type (N, % and In-Patient Length of Stay) _____________________________________________________________ 30 TABLE 2.7 Total Discharges (excl. Maternity): HSE Area of Hospitalisation by GMS Status and Patient Type (N, % and In- Patient Length of Stay) ___________________________________________________________________