SPARRA Version 3
In 2009, the Scottish Government’s ‘Improving the Health and Wellbeing of People with Long Term Conditions in Scotland: A National Action Plan’ committed ISD to expand the cohort for whom a risk score can be estimated beyond those with a recent hospital admission.
The primary objectives of this development were to:
- widen the SPARRA cohort to allow risk scores to be derived for more patients, and for patients from lower risk strata who may benefit from early preventative interventions. These individuals may be at an earlier stage in the development of their condition(s) prior to potentially entering a cycle of admission and readmission. Identifying such patients allows health services to plan and provide appropriate interventions and in turn, effective and timely intervention will help reduce unnecessary and inappropriate emergency admissions.
- improve the discriminatory power of the algorithm (i.e. improve the tool’s ability to correctly identify individuals at risk of emergency admission).
In order to meet this objective, ISD have developed SPARRA Version 3 built on a linked patient-level dataset which combines information on an individual’s:
- Hospital inpatient admissions
- Community dispensed prescriptions
- Emergency Department (ED) attendances
- New outpatient attendances
- Psychiatric inpatient admissions.
The new tool allows SPARRA scores to be calculated for 3.5 million individuals in Scotland. Moreover, 95% of patients experiencing an emergency hospital admission during a year appear in the enhanced SPARRA cohort. This compares with 40% for the previous SPARRA "All Ages" (Version 2) algorithm.
A key feature of Version 3 is the division of the SPARRA cohort into three sub-cohorts: frail elderly, long term conditions, and younger Emergency Department. These sub-cohorts each have their own specific set of risk factors tailored to the characteristics of these particular populations.
Following development, piloting and implementation during 2010 and 2011, SPARRA Version 3 went live in January 2012.
Details of the development of the SPARRA Version 3 algorithm, describing the methodology, data sources use, risk factors identified, and model performance can be found in A Report on the Development of SPARRA Version 3 
[161KB]. For users of SPARRA data, the SPARRA Version 3 User Information Sheet 
[36KB] provides more information as to how the Version 3 implementation impacts on routine outputs.
