COPD Analyses
Updated – 7th February 2011
7 February 2011
1
Table of Contents – COPD Indicators
COPD
o
C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute trust
o
C1.2 – Admissions to secondary care where COPD is the primary diagnosis by
o
C2.1 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by acute trust
o
C2.2 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by
o
C3.1 – Median length of stay for admissions to secondary care where COPD exacerbations are the primary
diagnosis by acute trust
o
C3.2 – Median length of stay for admissions to secondary care where COPD exacerbations are the primary
diagnosis by PCT
o
C4.1 – Current prevalence rate for COPD by PCT vs. Predicted rate by PCT
o
C4.2 – Current prevalence rate for COPD by GP practice vs. Predicted rate by PCT (data only and NE only)
o
C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by acute
o
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by PCT
2
C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute
trust
Data Table 1: Indirectly standardised ratio
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
94.28
101.64
103.34
109.54
102.55
107.37
116.40
102.53
137.45
113.41
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
167.92
160.52
163.63
185.64
169.63
159.65
172.54
137.17
140.69
150.39
GATESHEAD HEALTH NHS FOUNDATION TRUST
228.68
279.21
274.39
245.13
257.12
260.49
280.43
280.85
244.90
266.54
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
149.78
148.09
154.39
145.01
149.70
162.41
171.64
154.40
188.36
168.67
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
138.28
135.40
134.28
142.20
137.41
142.87
150.94
141.08
140.32
143.37
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
98.92
105.77
106.38
100.03
102.93
90.06
91.02
112.63
95.02
98.15
SOUTH TYNESIDE NHS FOUNDATION TRUST
169.73
162.71
168.18
163.05
166.17
150.28
202.35
215.63
196.10
192.19
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
82.40
89.76
84.81
80.82
84.28
83.30
89.17
76.00
78.70
81.23
NHS North East
124.35
128.17
129.08
130.17
128.07
127.01
136.66
128.98
132.83
131.06
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
248
226
366
327
1167
284
258
322
248
1112
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
390
310
514
469
1683
355
336
404
357
1452
GATESHEAD HEALTH NHS FOUNDATION TRUST
177
189
290
229
885
209
191
291
220
911
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
251
214
350
261
1076
269
245
306
329
1149
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
364
310
488
405
1567
373
334
445
378
1530
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
288
276
411
315
1290
258
226
395
301
1180
SOUTH TYNESIDE NHS FOUNDATION TRUST
132
110
174
130
546
111
130
197
152
590
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
282
272
383
294
1231
265
250
300
256
1071
NHS North East
2132
1907
2976
2430
9445
2124
1970
2660
2241
8995
NHS National
27485
24009
36809
29561
117864
26667
23205
32821
28260
110953
Data Table 1b: Observed values
Provider
Data obtained from HES 2008/09, 2009/10
3
C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute
trust
Chart 1: Time series (indirectly standardised ratio)
Admissions for COPD (indirectly
standardised ratio)
300
250
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
200
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION
TRUST
GATESHEAD HEALTH NHS FOUNDATION TRUST
150
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
100
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
SOUTH TYNESIDE NHS FOUNDATION TRUST
50
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION
TRUST
0
Data obtained from HES 2008/09, 2009/10
4
C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute
trust
Chart 2: Funnel Plot (indirectly standardised ratio)
Data obtained from HES 2009/10
5
C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT
Data Table 1: Directly standardised rate per 100,000 population
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
77
62
104
92
336
75
69
80
75
299
Darlington PCT
73
51
82
69
274
48
53
68
58
227
Gateshead PCT
82
83
133
113
411
97
90
133
99
418
Hartlepool PCT
76
74
128
95
373
96
71
108
126
401
Middlesbrough PCT
105
108
153
109
474
95
83
146
106
430
Newcastle PCT
89
87
121
85
383
76
71
92
82
321
Stockton-on-Tees
79
70
103
85
337
92
72
93
86
342
North Tyneside PCT
59
47
84
70
260
57
57
76
59
249
Northumberland Care Trust
66
62
94
87
309
68
56
104
83
311
Redcar And Cleveland PCT
82
71
107
78
338
68
81
122
95
366
South Tyneside PCT
69
55
87
67
279
75
62
85
87
309
Sunderland Teaching PCT
77
75
117
106
375
94
85
111
78
368
NHS North East
934
846
1313
1055
4150
941
850
1219
1034
4044
Data obtained from HES 2008/09, 2009/10 and ONS 2008
6
C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT
Data Table 1b: Observed values
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
419
337
563
499
1818
402
377
430
406
1615
Darlington PCT
78
55
87
73
293
51
57
72
62
242
Gateshead PCT
167
172
272
229
840
200
185
274
203
862
Hartlepool PCT
69
69
120
86
344
87
65
99
116
367
Middlesbrough PCT
136
141
198
143
618
124
108
192
137
561
Newcastle PCT
223
221
307
213
964
192
178
232
205
807
Stockton-on-Tees
125
102
157
121
505
134
113
152
157
556
North Tyneside PCT
169
150
222
181
722
196
153
199
184
732
Northumberland Care Trust
221
176
312
259
968
213
211
282
220
926
Redcar And Cleveland PCT
102
96
145
133
476
106
86
162
128
482
South Tyneside PCT
134
116
176
130
556
114
135
200
156
605
Sunderland Teaching PCT
219
210
330
303
1062
267
242
318
224
1051
NHS North East
2062
1845
2889
2370
9166
2086
1910
2612
2198
8806
NHS National
27485
24009
36809
29561
117864
26667
23205
32821
28260
110953
Data obtained from HES 2008/09, 2009/10
7
C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT
Chart 1: Time series (directly standardised rate per 100,000 population)
Admissions foro COPD per 100K population (directly
standardised rate)
180
160
140
120
County Durham PCT
Darlington PCT
Gateshead PCT
100
Hartlepool PCT
Middlesbrough PCT
80
Newcastle PCT
Stockton-on-Tees
North Tyneside PCT
60
Northumberland Care Trust
Redcar And Cleveland PCT
40
South Tyneside PCT
Sunderland Teaching PCT
20
0
Data obtained from HES 2008/09, 2009/10 and ONS 2008
8
C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT
Chart 2: Funnel Plot (directly standardised rate per 100,000 population)
Data obtained from HES 2009/10 and ONS 2008
9
C2.1 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by acute trust
Data Table 1: Indirectly standardised ratio
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
58.92
91.12
80.98
104.00
86.21
71.18
96.01
81.13
70.88
80.29
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
80.24
102.30
97.24
106.86
97.81
128.53
93.36
103.92
90.13
102.81
GATESHEAD HEALTH NHS FOUNDATION TRUST
78.48
108.46
80.48
102.54
93.00
79.75
125.14
120.25
114.34
111.89
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
73.46
75.95
98.93
111.76
92.20
80.25
117.53
83.63
90.95
93.13
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
96.83
103.75
83.01
71.66
87.10
105.29
113.82
138.16
111.70
118.49
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
99.48
94.79
71.54
86.54
86.36
84.68
85.20
74.41
90.47
82.91
SOUTH TYNESIDE NHS FOUNDATION TRUST
74.37
89.00
66.15
75.34
75.43
75.54
90.42
112.07
104.05
98.90
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
102.76
87.52
99.48
89.24
94.52
76.63
93.19
120.82
83.62
94.88
NHS North East
84.91
94.84
86.42
94.33
90.22
91.14
102.11
104.31
94.32
98.49
Data Table 1b: Observed values
Data obtained from HES 2008/09, 2009/10
10
C2.1 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by acute trust
Chart 1: Time series (indirectly standardised ratio)
30d Re-admissions for COPD (indirectly
standardised ratio)
160
140
120
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
100
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION
TRUST
GATESHEAD HEALTH NHS FOUNDATION TRUST
80
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
60
40
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
SOUTH TYNESIDE NHS FOUNDATION TRUST
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION
TRUST
20
0
Data obtained from HES 2008/09, 2009/10
11
C2.1 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by acute trust
Chart 2: Funnel Plot (indirectly standardised ratio)
Data obtained from HES 2009/10
12
C2.2 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by PCT
Data Table 1: Directly standardised rate per 100,000 population
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
8
11
14
16
49
11
12
10
10
42
Darlington PCT
5
7
13
15
40
12
7
15
8
42
Gateshead PCT
9
15
16
19
59
10
19
24
17
71
Hartlepool PCT
10
9
24
16
59
12
8
15
27
63
Middlesbrough PCT
18
17
18
20
73
8
11
25
18
62
Newcastle PCT
14
15
20
11
60
8
12
15
13
48
Stockton-on-Tees
4
7
12
12
35
7
13
14
11
44
North Tyneside PCT
9
10
12
12
44
13
12
20
14
60
Northumberland Care Trust
7
8
10
9
35
8
11
16
11
46
Redcar And Cleveland PCT
6
11
10
9
35
9
7
6
12
34
South Tyneside PCT
8
12
11
10
41
6
12
20
16
54
Sunderland Teaching PCT
6
12
14
19
51
8
15
15
10
49
104
133
174
168
580
113
140
196
167
616
NHS North East
Data obtained from HES 2008/09, 2009/10 and ONS 2008
13
C2.2 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by PCT
Data Table 1b: Observed values
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
45
59
76
87
267
59
64
52
56
231
Darlington PCT
5
7
14
16
42
13
8
16
8
45
Gateshead PCT
18
32
33
39
122
21
40
51
35
147
Hartlepool PCT
9
8
23
14
54
11
8
14
25
58
Middlesbrough PCT
23
22
24
27
96
11
14
33
23
81
Newcastle PCT
35
37
52
28
152
20
30
39
32
121
Stockton-on-Tees
7
14
21
21
63
12
23
25
19
79
North Tyneside PCT
20
22
26
26
94
28
26
43
31
128
Northumberland Care Trust
28
31
37
34
130
29
43
60
41
173
Redcar And Cleveland PCT
9
17
16
14
56
14
11
9
19
53
South Tyneside PCT
13
19
17
16
65
11
20
33
26
90
Sunderland Teaching PCT
17
32
39
54
142
24
44
44
30
142
NHS North East
229
300
378
376
1283
253
331
419
345
1348
NHS National
3599
4089
5497
4907
18092
3570
3958
5108
4683
17319
Data obtained from HES 2008/09, 2009/10
14
C2.2 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by PCT
Chart 1: Time series (directly standardised rate per 100,000 population
Admissions foro COPD per 100K population (directly
standardised rate)
30
25
20
County Durham PCT
Darlington PCT
Gateshead PCT
Hartlepool PCT
15
Middlesbrough PCT
Newcastle PCT
Stockton-on-Tees
North Tyneside PCT
10
Northumberland Care Trust
Redcar And Cleveland PCT
South Tyneside PCT
Sunderland Teaching PCT
5
0
Data obtained from HES 2008/09, 2009/10 and ONS 2008
15
C2.2 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by PCT (age-sex standardised to England population)
Chart 2: Funnel Plot (directly standardised rate per 100,000 population)
Data obtained from HES 2009/10 and ONS 2008
16
C3.1 – Median length of stay for admissions to secondary care where COPD
exacerbations are the primary diagnosis by acute trust
Data Table 1: Median length of stay (days) for admissions to secondary care where COPD
exacerbations are the primary diagnosis by acute trust
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
6
6
6
5
5
5
7
8
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
5
5
5
5
6
4
5
7
GATESHEAD HEALTH NHS FOUNDATION TRUST
3
4
3
3
3
4
3
4
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
5
4
4
4
4
4
6
3
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
5
5
5
4
4
5
6
5
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
3
3
3
3
4
4
3
3
SOUTH TYNESIDE NHS FOUNDATION TRUST
5
5
5
6
7
4
4
3
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
4
4
4
4
4
4
6
5
Data obtained from HES 2008/09, 2009/10
17
C3.2 – Median length of stay for admissions to secondary care where COPD
exacerbations are the primary diagnosis by PCT
Data Table 1: Median length of stay (days) for admissions to secondary care where COPD
exacerbations are the primary diagnosis by PCT
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
County Durham PCT
5
5
5
5
6
4
5
5
Darlington PCT
5
4
6
5
4
4
3
5
Gateshead PCT
3
4
3
3
4
4
4
4
Hartlepool PCT
6
5
4
4
4
4
5
4
Middlesbrough PCT
3
2
3
3
3
3
3
2
Newcastle PCT
4
4
4
4
4
4
4
4
Stockton-on-Tees
4
4
5
5
4
5
5
5
North Tyneside PCT
6
5
6
5
5
6
5
4
Northumberland Care Trust
4
4
5
4
3
5
5
4
Redcar And Cleveland PCT
3
4
4
3
3
3
3
4
South Tyneside PCT
5
5
5
6
6
6
5
5
Sunderland Teaching PCT
6
5
6
5
5
6
6
5
Data obtained from HES 2008/09, 2009/10
18
C4.1 – Current prevalence for COPD by PCT vs. Predicted by PCT
Data Table 1: Ratio of reported vs expected COPD (Current / Predicted)
Data obtained from NHS Comparators 2005/06, 2006/07, 2007/08, 2008/09
and ERPHO modelled estimates of prevalence 2006 - 2009
19
C4.1 – Current prevalence for COPD by PCT vs. Predicted by PCT
Chart 1: Ratio of reported vs expected COPD (Current / Predicted)
Data obtained from NHS Comparators 2005/06, 2006/07, 2007/08, 2008/09
and ERPHO modelled estimates of prevalence 2006 - 2009
20
C4.2 – Current prevalence for COPD by GP practice vs. Predicted by PCT
Data Table 1: Ratio of reported vs expected COPD (Current / Predicted)
Please see excel supplement for data table by GP practice
Data obtained from NHS Comparators 2008/09
21
C4.2 – Current prevalence for COPD by GP practice vs. Predicted by PCT
Chart 1: Ratio of reported vs expected COPD (Current / Predicted)
Ratio of reported vs expected prevalence
3
2.5
2
1.5
1
GP practices
Linear (North East SHA)
0.5
Linear (National)
0
Data obtained from NHS Comparators 2008/09
22
C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by
acute trust
Data Table 1: Indirectly standardised ratio
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
143.35
103.32
111.96
90.47
111.55
103.20
113.38
106.44
115.66
109.21
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
76.73
66.80
62.49
130.74
84.49
92.40
146.96
103.94
87.27
105.58
GATESHEAD HEALTH NHS FOUNDATION TRUST
65.41
82.56
109.06
66.00
85.22
73.78
67.59
57.42
41.45
59.00
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
152.78
110.23
101.01
41.61
100.84
70.90
70.33
65.52
73.29
70.00
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
78.63
69.45
73.47
76.07
74.62
56.15
54.70
63.11
61.63
59.47
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
60.90
94.40
79.32
91.29
80.84
81.99
83.77
125.29
134.43
111.46
SOUTH TYNESIDE NHS FOUNDATION TRUST
83.80
52.03
79.88
77.20
75.08
76.91
85.19
61.33
78.82
73.78
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
114.52
56.69
71.44
79.29
80.41
63.12
84.46
103.95
113.18
92.90
NHS North East
96.07
80.15
84.03
86.38
86.56
77.45
90.82
87.27
87.75
85.82
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
21
13
28
16
78
14
13
17
14
58
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST
17
11
22
35
85
16
22
22
17
77
GATESHEAD HEALTH NHS FOUNDATION TRUST
7
9
23
9
48
8
6
9
5
28
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
22
12
23
6
63
9
7
10
12
38
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
17
11
25
18
71
10
8
15
12
45
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
10
13
22
16
61
10
8
24
21
63
SOUTH TYNESIDE NHS FOUNDATION TRUST
6
3
9
6
24
4
5
6
6
21
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
18
7
18
12
55
7
8
15
14
44
NHS North East
118
79
170
118
485
78
77
118
101
374
NHS National
1599
1275
2504
1701
7079
1270
1032
1685
1488
5475
Data Table 1b: Observed values
Provider
Data obtained from HES 2008/09, 2009/10
23
C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by
acute trust
Chart 1: Time series (indirectly standardised ratio)
In-hospital mortality for COPD (indirectly
standardised ratio)
180
160
140
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST
120
100
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION
TRUST
GATESHEAD HEALTH NHS FOUNDATION TRUST
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
80
60
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST
SOUTH TYNESIDE NHS FOUNDATION TRUST
40
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION
TRUST
20
0
Data obtained from HES 2008/09, 2009/10
24
C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by
acute trust
Chart 2: Funnel Plot (indirectly standardised ratio)
Data obtained from HES 2009/10
25
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by
PCT
Data Table 1: Directly standardised rate per 100,000 population
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
2
3
6
6
17
2
4
4
3
14
Darlington PCT
8
1
2
8
18
5
6
2
2
14
Gateshead PCT
4
4
11
5
24
3
3
5
3
14
Hartlepool PCT
8
1
4
4
18
3
2
4
4
12
Middlesbrough PCT
3
5
2
5
15
2
3
7
11
22
Newcastle PCT
6
2
6
4
18
2
2
4
4
13
Stockton-on-Tees
6
3
8
2
18
3
2
3
6
15
North Tyneside PCT
5
4
5
3
16
3
1
4
3
11
Northumberland Care Trust
2
1
5
4
12
1
2
3
2
9
Redcar And Cleveland PCT
3
2
8
6
19
5
3
9
2
19
South Tyneside PCT
3
2
6
3
14
3
4
4
4
14
Sunderland Teaching PCT
8
5
9
5
26
5
4
7
5
20
NHS North East
57
33
71
53
215
37
37
55
48
176
Data obtained from HES 2008/09, 2009/10 and ONS 2008
26
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by
PCT
Data Table 1b: Observed values
Provider
Q1 0809
Q2 0809
Q3 0809
Q4 0809
FY 0809
Q1 0910
Q2 0910
Q3 0910
Q4 0910
FY 0910
County Durham PCT
13
16
30
30
89
13
19
21
17
70
Darlington PCT
8
1
2
8
19
5
6
2
2
15
Gateshead PCT
7
9
23
10
49
6
7
9
6
28
Hartlepool PCT
7
1
4
3
15
2
2
3
3
10
Middlesbrough PCT
4
6
3
6
19
2
4
9
14
29
Newcastle PCT
15
6
15
11
47
6
5
11
11
33
Stockton-on-Tees
10
5
14
3
32
6
4
6
10
26
North Tyneside PCT
11
8
10
6
35
6
3
8
6
23
Northumberland Care Trust
8
4
17
13
42
5
7
11
9
32
Redcar And Cleveland PCT
4
4
12
9
29
7
5
14
3
29
South Tyneside PCT
5
3
10
6
24
5
7
6
6
24
Sunderland Teaching PCT
22
13
23
13
71
14
10
18
13
55
NHS North East
114
76
163
118
471
77
79
118
100
374
NHS National
1599
1275
2504
1701
7079
1270
1032
1685
1488
5475
Data obtained from HES 2008/09, 2009/10
27
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by
PCT
Chart 1: Time series (directly standardised rate per 100,000 population)
In-hospital mnortality for COPD per 100K population
(directly standardised rate)
12
10
8
County Durham PCT
Darlington PCT
Gateshead PCT
Hartlepool PCT
6
Middlesbrough PCT
Newcastle PCT
Stockton-on-Tees
North Tyneside PCT
4
Northumberland Care Trust
Redcar And Cleveland PCT
South Tyneside PCT
Sunderland Teaching PCT
2
0
Data obtained from HES 2008/09, 2009/10 and ONS 2008
28
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by
PCT
Chart 2: Funnel Plot (directly standardised rate per 100,000 population)
Data obtained from HES 2008/09, 2009/10 and ONS 2008
29
DATA SPECIFICATIONS
HIGH LEVEL NOTES
30
General Notes for all Indicators – Data Details
•
HES primary diagnosis (diag_01) in list of ICD10 codes
NOTE – due to variation in coding practices and other differences amongst trusts, it is
possible that the diagnosis of COPD may not be coded in the primary position although
it is, in fact, the primary cause for the hospital admission. Consequently, relevant
episodes may be omitted from this analysis by limiting the COPD diagnosis to the
primary position.
However, by expanding the selection of episodes to include those where COPD is in any
position runs the risk of including episodes where the actual primary diagnosis (e.g.
Fracture) has no relation to the COPD condition.
Therefore, in order to include in the analyses only those episodes for which COPD was
the primary cause for admission, the decision was made to limit selection of episodes
only to those where COPD was coded as the primary diagnosis.
31
C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute
trust
•
Data Source:
HES in-patient data 2008/09, 2009/10
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Number of admissions where the primary diagnosis is COPD by acute trust,
standardised by age and sex
Numerator = COPD admissions
Denominator = All secondary care admissions
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Indirectly standardised for age and sex
32
C1.2 –Admissions to secondary care where COPD is the primary diagnosis by PCT
•
Data Source:
HES in-patient data 2008/09, 2009/10
ONS data 2008/09
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Number of admissions where the primary diagnosis is COPD by PCT, standardised by
age and sex
Numerator = COPD admissions
Denominator = PCT population
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Referring PCT field will be used
Directly standardised for age and sex per 100,000 population
33
C2.1 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by acute trust
•
Data Source:
HES in-patient data 2008/09, 2009/10
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Number of admissions where the primary diagnosis is COPD by acute trust,
standardised by age and sex
Numerator = 30 day COPD readmissions
Denominator = All secondary care admissions
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Indirectly standardised for age and sex
34
C2.2 – Readmissions within 30d to secondary care where COPD is the primary
diagnosis by PCT
•
Data Source:
HES in-patient data 2008/09, 2009/10
ONS data 2008/09
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Number of admissions where the primary diagnosis is COPD by PCT, standardised by
age and sex
Numerator = 30 day COPD readmissions
Denominator = PCT population
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Referring PCT field will be used
Directly standardised for age and sex per 100,000 population
35
C3.1 – Median length of stay for admissions to secondary care where COPD
exacerbations are the primary diagnosis by acute trust
•
Data Source:
HES in-patient data 2008/09, 2009/10
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Median length of stay for admissions to secondary care where the primary diagnosis is
in the list of COPD exacerbations, by acute trust
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
36
C3.2 – Median length of stay for admissions to secondary care where COPD
exacerbations are the primary diagnosis by PCT
•
Data Source:
HES in-patient data 2008/09, 2009/10
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
•
Indicator:
Median length of stay for admissions to secondary care where the primary diagnosis is
in the list of COPD exacerbations, by PCT
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Referring PCT field will be used
37
C4.1 – Current prevalence rate for COPD by PCT vs. Predicted rate by PCT
•
Data Source:
NHS Comparators 2005/06, 2006/07, 2007/08, 2008/09 and ERPHO modelled estimates of prevalence of COPD for PCTs in
England (http://www.erpho.org.uk/viewResource.aspx?id=18025)
•
Data Details:
The ERPHO estimates and were derived using a model developed at the Dept of Primary Care and Social Medicine,
Imperial College, London. The model was developed using data from the 2001 Health Survey for England. The model takes
into account age, sex, ethnicity, smoking status, rurality and deprivation score.
•
Indicator:
Numerator = Count of patients recorded by practice as having COPD as reported in QOF data summed to the PCT level
Denominator = Expected count of patients by PCT
38
C4.2 – Current prevalence rate for COPD by GP practice vs. Predicted rate
by PCT
•
Data Source:
NHS Comparators 2008/09
•
Data Details:
The ERPHO rates were derived using GP Practice list data. To match with QOF populations, ERPHO prevalence rates at GP
practice level for the population aged 16 and over were applied to the estimated QOF list population of the practice aged
16 and over. NB assumption of zero rate in population less than 16
Some practices in QOF have no modelled prevalence rates in the ERPHO data - including all practices that formed after
March 2007 were not included in the modelled data. For these practices (138 in 2007/08 and 155 in 2008/09) the national
modelled prevalence rate has been applied for both years (for COPD 3.63% of practice population aged 16 and over)
Details of the COPD model used can be found at http://www.erpho.org.uk/viewResource.aspx?id=18026
Modelled estimates are published on the APHO website. http://www.apho.org.uk/resource/item.aspx?RID=77180
•
Indicator:
Numerator = Count of patients recorded by practice as having COPD as reported in QOF data by GP practice
Denominator = Expected count of patients by practice on the disease register by PCT
(Expected prevalence data are derived using expected prevalence rates provided by ERPHO which take account of age, sex,
ethnicity, smoking status and deprivation score at practice level)
•
Data Handling Notes:
This will be a high volume of data so will be delivered as raw data and summary statistics
and limited to NE GP practices
39
C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by
acute trust
•
Data Source:
HES in-patient data 2008/09, 2009/10
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
HES discharge method equal to Death
•
Indicator:
Number of admissions where the primary diagnosis is COPD where patient dies by
acute trust, standardised by age and sex
Numerator = Number of deaths for COPD admissions
Denominator = Number of COPD admissions
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Indirectly standardised for age and sex
40
C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by
PCT
•
Data Source:
HES in-patient data 2008/09, 2009/10
ONS data 2008/09
•
Data Details:
HES primary diagnosis (diag_01) in list of ICD10 codes
HES discharge method equal to Death
•
Indicator:
Number of admissions where the primary diagnosis is COPD where patient dies by
PCT, standardised by age and sex
Numerator = Number of deaths for COPD admissions
Denominator = PCT population
•
Data Handling Notes:
ICD10 Codes for COPD - J411, J420, J430, J431, J432, J438, J439, J440, J441, J448, J449
Referring PCT field will be used
Directly standardised for age and sex per 100,000 population
41
COPD ICD10 Codes
•
•
•
•
•
•
•
•
•
J41.1 Mucopurulent chronic bronchitis
J42.0 Unspecified chronic bronchitis
J43.0 Emphysema
J43.1 Panlobular emphysema - Panacinar emphysema
J43.2 Centrilobular emphysema
J43.8 Other emphysema
J43.9 Emphysema, unspecified
J44.0 Other chronic obstructive pulmonary disease
J44.1 Chronic obstructive pulmonary disease with acute
exacerbation, unspecified
• J44.8 Other specified chronic obstructive pulmonary disease
• J44.9 Chronic obstructive pulmonary disease, unspecified
42