Trends in Hospital Admissions Due to Neoplasms in England and Wales between 1999 and 2019: An Ecological Study

Medication prescription profile and hospital admission related to medication administration errors in England and Wales: an ecological study

OBJECTIVE

To explore the correlation between prescribing rate of medications and hospital admissions related to medications administration errors in England and Wales during the time from 1999 to 2020.

DESIGN

An ecological study.

SETTING

A population-based study using hospital admission data that are publicly available in the UK. Data in this study were extracted from the Hospital Episode Statistics database in England and the Patient Episode Database in Wales from Wales. The Prescription Cost Analysis database was used to extract the prescription data.

PARTICIPANTS

Patients who were hospitalised all National Health Service (NHS) trusts and any independent sector funded by NHS trusts.

PRIMARY OUTCOME MEASURE

Hospitalisation rates related to medication administration errors and its associated prescriptions.

RESULTS

The annual rate of hospital admissions related to medication administration errors increased by 32.0% (from 184.21 (95% CI 183.0 to 185.4) in 1999 to 243.18 (95% CI 241.9 to 244.4) in 2020 per 100 000 persons. The most common three indications of hospital admissions were T39 (non-opioid analgesics, antipyretics and antirheumatics), T43 (psychotropic drugs), T42 (antiepileptic, sedative-hypnotic and antiparkinsonism drugs). The age group 15-59 years had the highest number of hospital admissions (83.4%). Women contributed to 59.1% of the total number of hospital admissions. Admission rate among men increased by 16.7%. Among women, the admission rate increased by 44.6%.

CONCLUSION

Admission rates due to medication administration errors increased markedly in the past decade. This increase was correlated with an increase in the prescription rate of several therapeutic classes. Patients taking non-opioid analgesics, antipyretics and antirheumatics, psychiatric medications, antiepileptic, sedative-hypnotic and antiparkinsonism drugs should have their recommended (and administered) doses closely monitored. They should be followed up on a regular basis to ensure that they are taking their medications as prescribed.

Trends in hospital admission related to poisoning by, narcotics and psychodysleptics and poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism drugs in England and Wales between April 1999 and April 2020: An ecological study

Background

This study aimed to investigate the trend of hospital admissions related to poisoning by narcotics and psychodysleptics and poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism drugs in England and Wales between April 1999 and April 2020.

Methods

An observational ecological study were conducted using data from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. The rate of hospital admissions with 95% confidence intervals (CIs) was calculated by dividing the number of episodes of poisoning by narcotics and psychodysleptics related admission and poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism drugs-related admission by the mid-year population from the Office for National Statistics. All analyses were conducted using SPSS version 27.

Results

The total annual number of hospital admissions for narcotics and psychodysfunctionals poisonings increased by 1.40-fold [from 15.70 (95% CI 15.36-16.04) in 1999 to 37.64 (95% CI 37.15-38.13) in 2020 per 100,000 people, p < 0.01]. However, the overall annual number of poisonings by antiepileptic, sedative-hypnotic and antiparkinsonism drugs hospital admissions for various reasons decreased by 12.8% [from 33.55 (95% CI 33.05-34.04) in 1999 to 29.26 (95% CI 28.82-29.69) in 2020 per 100,000 persons, p < 0.05]. Poisoning by other opioids (53.2%), heroin (15.1%), and other synthetic narcotics (13.3%) were the most common reasons for narcotic and psychodysfunctional poisoning. While poisoning by benzodiazepines (54.2%) and poisoning: other antiepileptic and sedative-hypnotic drugs (30.7%) were the most common hospital admission reasons for poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism.

Conclusion

Poisoning by narcotics have increased in England and Wales over the study period, however, poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism drugs in England and Wales were relatively stable during the same period. Future initiatives and awareness programs to prevent harmful use and drug poisoning by narcotics, sedative-hypnotic and other medications are needed.

Hospital Admission Profile Related to Inner Ear Diseases in England and Wales

BACKGROUND

Due to an expansion in the usage of medications (such as anticancer therapies), increased exposure to noise, and an increase in life expectancy, the prevalence of inner ear disease-related hearing loss is rising. Diseases of the inner ear are frequently accompanied by other conditions, such as chronic heart failure, systemic inflammation, arterial hypertension, and cerebrovascular disease. The aim of this study was to investigate the profile of hospital admissions linked to inner ear diseases in England and Wales.

METHOD

This was an ecological descriptive study using public medical databases in England and Wales. Diagnostic codes for diseases of the inner ear (H80-H83) were used to identify all hospital admissions. Between 1999 and 2020, the chi-squared test was used to assess the difference between the admission rates.

RESULTS

From 5704 in 1999 to 19,097 in 2020, the total annual number of hospital admissions increased by 234.8%, which corresponds to a 192.3% increase in the admission rate [from 10.94 (95% CI 10.66-11.22) in 1999 to 31.98 (95% CI 31.52-32.43) in 2020 per 100,000 people, p < 0.01]. "Disorders of vestibular function" and "other inner ear diseases" were the most frequent causes of hospital admissions due to inner ear diseases, accounting for 47.6% and 43.6%, respectively. The age range of 15 to 59 years accounted for 42.3% of all diseases of the inner ear hospital admissions. Around 59.6% of all admissions were made by females. The female admission rate increased by 210.1% (from 12.43 (95% CI 12.01-12.85) in 1999 to 38.54 (95% CI 37.84-39.24) in 2020 per 100,000 people). The male admission rate for diseases of the inner ear increased by 169.6% [from 9.37 (95% CI 9.00-9.75) in 1999 to 25.26 (95% CI 24.69-25.84) per 100,000 people] in 2020.

CONCLUSION

Inner ear disease admissions increased markedly in England and Wales during the past two decades. Females and the middle-aged population were at higher risk of being admitted for inner ear diseases. Further cohort studies are warranted to identify other risk factors and develop effective prevention strategies.

Hospitalisation profile in England and Wales, 1999 to 2019: an ecological study

OBJECTIVE

Hospital-related indicators are used to prioritise, benchmark and monitor certain healthcare components to improve quality. This study aimed to determine the hospital admissions profile in England and Wales between 1999 and 2019.

DESIGN

Ecological study.

SETTING

A population-based study of hospitalised patients in England and Wales.

PARTICIPANTS

All patients of all ages and genders who were hospitalised in National Health Service (NHS) hospitals and NHS-funded independent sector hospitals.

OUTCOME MEASURE

Hospital admission rates in England and Wales related to various diseases/causes, which were identified using the diagnostic codes (A00-Z99).

RESULTS

There was a 48.5% rise in hospital admission rates from 246 366.7 (95% CI 246 249.8 to 246 483.7) in 1999 to 365 858.7 (95% CI 365 736.3 to 365 981.2) in 2019 per million persons (p<0.05). The most common causes of hospital admissions were diseases of the digestive system; symptoms, signs, and abnormal clinical and laboratory findings; and neoplasms, which accounted for 11.5%, 11.4% and 10.5%, respectively. The age range of 15-59 years accounted for 43.4% of all hospital admissions. Around 56.0% of all hospital admissions were by female patients. In comparison to 1999, the hospital admission rate for males grew by 53.7%, from 218 363.7 (95% CI 218 203.2 to 218 524.3) to 335 618.9 (95% CI 335 448.1 to 335 789.6) per million persons in 2019. When compared with 1999, the hospital admission rate for females increased by 44.7%, rising from 273 032.5 (95% CI 272 863.5 to 273 201.5) to 395 154.6 (95% CI 394 979.9 to 395 329.4) per million persons.

CONCLUSION

A notable increase was observed in the rate of hospital admissions for all causes in England and Wales. Elderly age and female gender were significant factors that influenced the rate of hospital admissions. Future research is required to identify preventable risk factors for hospital admission.

Admissions Due to Perinatal Respiratory and Cardiovascular Disorders in England

Objective

The aim of this study was to look into the rates of perinatal admissions for respiratory, cardiac, and cardiovascular diseases in England.

Methods

This ecological study was conducted in England. The Hospital Episode Statistics (HES) database in England provided the study with the publicly accessible data. The data set for this study was considered between April 01, 2012 and April 01, 2020. The HES database contains information on patients' admissions to hospitals, notably for those hospitalised with perinatal cardiovascular and respiratory diseases. We used the chi-squared test to assess the difference between the hospital admission rates between 2012 and 2020.

Results

An increase of 15.6% was observed in hospital admissions rate during the study period [from 10,940.37 (95% CI 10,865.99-11,014.75) in 2012 to 12,649.00 (95% CI 12,565.03-12,732.98) in 2020 per 100,000 people, p<0.05]. Intrauterine hypoxia, chest congestion and breathing-related respiratory distress of newborns, and other perinatal respiratory disorders accounted for 35.5%, 29.8%, and 21.3%, respectively. Males contributed for more than half of them (56.7%). The rate of hospital admission among males increased by 15.1% [from 12,227.79 (95% CI 12,118.83-12,336.74) in 2012 to 14,074.77 (95% CI 13,952.11-14,197.43) in 2020 per 100,000 persons, p<0.05]. The rate of hospital admission among females increased by 17.4% [from 9,646.15 (95% CI 9,545.31-9,747.00) in 2012 to 11,324.20 (95% CI 11,209.47-11,438.92) in 2020 per 100,000 persons, p<0.05].

Conclusion

The study's findings show that the most common causes of hospital admissions for respiratory and cardiovascular disorders were intrauterine hypoxia, neonatal respiratory distress, and other perinatal respiratory issues, which were detected particularly during the perinatal period. Further research is warranted to identify risk factors of hospital admissions for respiratory and cardiovascular disorders during the perinatal period.

Trend of Admissions Due to Chronic Lower Respiratory Diseases: An Ecological Study

Objective: This study aimed to examine the trend of hospital admissions related to chronic lower respiratory diseases in England and Wales between 1999 and 2020. Method: This ecological analysis used data that were made accessible to the public and were taken from the Patient Episode Database for Wales (PEDW) and the Hospital Episode Statistics (HES) databases in England for the time span between April 1999 and April 2020. The patients were grouped into four age groups: under 15, 15−59, 60−74, and 75 years and above. Results: In 2020, there were 432,193 chronic lower respiratory disease hospital admissions, which increased from 239,606 in 1999. The hospital admission rate increased by 57.5% (from 459.54 (95% CI 457.71−461.38) in 1999 to 723.70 (95% CI 721.55−725.85) in 2020 per 100,000 people, p < 0.5). The majority of hospital admissions for chronic lower respiratory diseases were found to be directly linked to age (more prevalent in the 75+ age group). Moreover, female hospital admission rates for chronic lower respiratory diseases grew by 85.2% between 1999 and 2020, increasing from 445.45 (95% CI 442.92−447.97) to 824.96 (95% CI 821.73−828.19) per 100,000 people. Conclusion: The rate of hospital admissions due to chronic lower respiratory diseases has sharply increased during the past two decades. COPD was the most common cause for chronic lower respiratory disease admissions. Ageing was also found to be a factor in increased hospital admissions. Future studies are warranted to identify other risk factors of hospital admissions due to chronic lower respiratory diseases and specifically COPD.

Hospitalization Pattern for Chronic Lower Respiratory Diseases in Australia: A Retrospective Ecological Study

BACKGROUND

Chronic lower respiratory diseases are among the commonest causes of hospital admission worldwide. Identifying the trends in hospital admission due to chronic lower respiratory diseases is important for public health and policy makers.

AIM

The aim of this study was to examine the hospitalization profile related to chronic lower respiratory diseases in Australia during the past 21 years.

METHOD

A retrospective ecological study was conducted using hospital admission data taken from the National Hospital Morbidity Database (NHMD). Hospital admissions data for chronic lower respiratory diseases were extracted for the period between 1998 and 2019. The Pearson Chi-square test for independence was used to estimate the variation in hospital admission rates.

RESULTS

The hospitalization rate for chronic lower respiratory diseases rate decreased by 14.4%, from 568.90 (95%CI 565.50-572.30) in 1998 to 486.95 (95%CI 484.24-489.66) in 2019 per 100,000 persons, p<0.05. Rates of same-day hospitalization for chronic lower respiratory diseases increased by 62.7% from 1998 to 2019, while rates of overnight-stay hospital admission for chronic lower respiratory diseases decreased by 23.7% from 1998 to 2019. During the study duration, the hospitalization rates for bronchiectasis and other chronic obstructive pulmonary disease increased by 120.0% and 34.7%, respectively. The hospital admissions rates for emphysema, status asthmaticus, simple and mucopurulent chronic bronchitis, bronchitis, not specified as acute or chronic, unspecified chronic bronchitis, and asthma decreased by 94.8%, 92.6%, 70.7%, 66.3%, 46.0%, and 32.3%, respectively. The rates of hospitalization among patients aged 75 years and above increased by 3.9%, while younger age groups including those aged younger than 15 years, 15-59 years, and 60-74 years showed a reduction in the rate of hospitalization by 53%, 22.8%, and 19.7%, respectively.

CONCLUSION

Overall, the hospitalization rate for chronic lower respiratory diseases is seen to have decreased over the study period. Patients with chronic obstructive pulmonary disease (COPD) and the elderly group have a higher rate of hospitalization. Future studies are needed to investigate factors associated with the increase in the rate of hospitalization among the elderly age group.

Musculoskeletal System and Connective Tissue Related Hospital Admission in England and Wales Between 1999 and 2019: An Ecologic Study

Background There is a lack of data describing inpatient hospitalization trends for musculoskeletal and connective tissue diseases in the United Kingdom. Aim We aim to provide a comprehensive analysis of the trends of musculoskeletal and connective tissue disease related hospitalizations between 1999 and 2019 in England and Wales. Method We conducted an ecologic study. The data were obtained from the Hospital Episode Statistics database in England and the Patient Episode Database in Wales between 1999 and 2019. We used ICD-10 (International Classification of Diseases, 10th Revision) codes M00-M99 to identify hospital admissions. Results The total annual hospital admission rate increased from 1,303.63 (95% CI: 1,300.55-1,306.71) in 1999 to 2,479.09 (95% CI: 2,475.14-2,483.04) in 2019 per 100,000 persons (p<0.01). The ICD-10 categories other joint disorders, osteoarthritis, and other dorsopathies accounted for 19.6%, 19.6%, and 18.6% of hospitalizations, respectively. Advanced age groups experienced a larger increase in hospitalization rates (128.6% in the age group of 75 years and above vs. 45.9% in the age group below 15 years). Females contributed to 57.7% of hospitalizations and experienced a larger increase in hospitalization rate compared to males (103.8% vs. 73.8%). Conclusion Between 1999 and 2009, the hospitalization rate for musculoskeletal and connective tissue diseases has steadily increased in England and Wales. However, the rate has plateaued or declined in many of musculoskeletal and connective tissue diseases between 2010 and 2019. Due to the chronicity of these diseases, their significant morbidity, and significant long-term disability, national interventions are needed to mitigate the effects of the increased cost of treatment.

Trends in Hospital Admissions for Mental, Behavioural and Neurodevelopmental Disorders in England and Wales between 1999 and 2019: An Ecological Study

Objectives: To investigate the trends in hospital admissions for mental, behavioural and neurodevelopmental disorders (MBNDs) in England and Wales. Methods: This is an ecological study using the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data was collected for the period between April 1999 and March 2019. Results: The most common type of hospital admission was for mental and behavioural disorders due to psychoactive substance use, which accounted for 26.6%. The admission rate among males increased by 8.1% [from 479.59 (95% CI 476.90−482.27) in 1999 to 518.30 (95% CI 515.71−520.90) in 2019 per 1000 persons; p < 0.001]. The admission rate among females increased by 0.3% [from 451.45 (95% CI 448.91−453.99) in 1999 to 452.77 (95% CI 450.37−455.17) in 2019 per 1000 persons; p = 0.547]. The 15−59 years’ age group accounted for 65.1% of the entire number of such hospital admissions, followed by the 75 years and above age group, with 19.0%. Conclusion: We observed an obvious variation in MBNDs influenced by age and gender. Observational studies are needed to identify other factors associated with increased hospital admission rates related to MBNDs, specifically among the young population (aged 15−59 years) and males.

Hospital Admissions Related to Infections and Disorders of the Skin and Subcutaneous Tissue in England and Wales

OBJECTIVES

To investigate hospital admissions in England and Wales due to infections and diseases of the skin and subcutaneous tissue.

METHODS

Data from the Patient Episode Database for Wales (PEDW) and the Hospital Episode Statistics (HES) database in England for the years between April 1999 and April 2020 were used in this study. Using all the relevant diagnosis codes (L00-L99), hospital admissions related to various skin infections and diseases of the subcutaneous tissue were identified.

RESULTS

Hospital admissions for all causes increased overall by 78.8%, from 276,464 in 1999 to 494,433 in 2020, representing an increase in hospital admission rate of 56.1% (from 530.23 (95% CI 528.26-532.20) in 1999 to 827.92 (95% CI 825.62-830.22) per 100,000 people in 2020, p ≤ 0.05). The most prevalent diagnoses were disorders of the skin's appendages, infections of the skin and subcutaneous tissue, and other disorders of the skin and subcutaneous tissue. Nearly half of all hospital admissions were for males and for patients between the ages of 15 and 59. In 2020, the hospital admission rate for males increased by 60.2%, from 540.16 (95% CI 537.32-543.01) per 100,000 people in 1999 to 865.10 (95% CI 861.76-868.44) in 2020. From 520.75 (95% CI 518.02-523.48) in 1999 to 791.03 (95% CI 787.86-794.19) in 2020, the hospital admission rate for females grew by 51.9%.

CONCLUSION

Hospital admission due to infections and disorders of the skin and subcutaneous tissue increased during the past two decades in England and Wales. Further studies are needed to explore the risk factors associated with infections and disorders of the skin and subcutaneous tissue complications, and its associated admissions.