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COPD Analyses Updated – 7th February 2011

COPD Analyses Updated – 7th February 2011. Table of Contents – COPD Indicators. COPD C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute trust C1.2 – Admissions to secondary care where COPD is the primary diagnosis by

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COPD Analyses Updated – 7th February 2011

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  1. COPD AnalysesUpdated – 7th February 2011 7 February 2011

  2. Table of Contents – COPD Indicators COPD • C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute trust • C1.2 – Admissions to secondary care where COPD is the primary diagnosis by • C2.1 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by acute trust • C2.2 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by • C3.1 – Median length of stay for admissions to secondary care where COPD exacerbations are the primary diagnosis by acute trust • C3.2 – Median length of stay for admissions to secondary care where COPD exacerbations are the primary diagnosis by PCT • C4.1 – Current prevalence rate for COPD by PCT vs. Predicted rate by PCT • C4.2 – Current prevalence rate for COPD by GP practice vs. Predicted rate by PCT (data only and NE only) • C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by acute • C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by PCT

  3. C1.1 – Admissions to secondary care where COPD is the primary diagnosis by acute trust Data Table 1: Indirectly standardised ratio Data Table 1b: Observed values 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 1: Time series (indirectly standardised ratio) Data obtained from HES 2008/09, 2009/10

  5. 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

  6. C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT Data Table 1: Directly standardised rate per 100,000 population Data obtained from HES 2008/09, 2009/10 and ONS 2008

  7. C1.2 – Admissions to secondary care where COPD is the primary diagnosis by PCT Data Table 1b: Observed values Data obtained from HES 2008/09, 2009/10

  8. 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) Data obtained from HES 2008/09, 2009/10 and ONS 2008

  9. 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

  10. C2.1 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by acute trust Data Table 1: Indirectly standardised ratio Data Table 1b: Observed values 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 1: Time series (indirectly standardised ratio) Data obtained from HES 2008/09, 2009/10

  12. 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

  13. 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 Data obtained from HES 2008/09, 2009/10 and ONS 2008

  14. C2.2 – Readmissions within 30d to secondary care where COPD is the primary diagnosis by PCT Data Table 1b: Observed values Data obtained from HES 2008/09, 2009/10

  15. 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 Data obtained from HES 2008/09, 2009/10 and ONS 2008

  16. 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

  17. 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 Data obtained from HES 2008/09, 2009/10

  18. 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 Data obtained from HES 2008/09, 2009/10

  19. 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

  20. 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

  21. 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

  22. C4.2 – Current prevalence for COPD by GP practice vs. Predicted by PCT Chart 1: Ratio of reported vs expected COPD (Current / Predicted) Data obtained from NHS Comparators 2008/09

  23. C5.1 – In-hospital mortality for admissions where COPD is the primary diagnosis by acute trust Data Table 1: Indirectly standardised ratio Data Table 1b: Observed values 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 1: Time series (indirectly standardised ratio) Data obtained from HES 2008/09, 2009/10

  25. 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

  26. 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 Data obtained from HES 2008/09, 2009/10 and ONS 2008

  27. C5.2 – In-hospital mortality for admissions where COPD is the primary diagnosis by PCT Data Table 1b: Observed values Data obtained from HES 2008/09, 2009/10

  28. 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) Data obtained from HES 2008/09, 2009/10 and ONS 2008

  29. 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

  30. Data specificationsHigh level notes

  31. 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.

  32. 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

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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 PCTsin 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

  39. 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

  40. 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

  41. 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

  42. 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

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