Page last updated: 29-JUN-2010

Inpatient, Day Case and Outpatient Activity

Multiple and All Emergency Admissions -  Interpretation Notes

All Emergency Admissions

An emergency admission is defined as being a new continuous spell of care in hospital where the patient was admitted as an emergency.

The total number of emergency admissions is then calculated by counting the number of continuous spells in hospital within a financial year.

From December 2009, all ISD National Statistics publications for Multiple and All Emergency Admissions and Bed Days data will be based on the date of discharge rather than the date of admission. This change has been made in order to provide more accurate, relevant and complete data, particularly in relation to bed days information. Displaying the data by date of discharge means that more complete stays are included in the analysis. An emergency admission is only counted if the date of discharge associated with the spell of hospital care is with the financial years specified.

The date of discharge for a continuous spell of hospital care is derived from the last episode of the spell of treatment.

  • If a patient was admitted as an emergency on 1st December 2006 and discharged on or before 31st March 2007, the patient would be counted as an emergency admission for the financial year ending 31st March 2007. If a patient was admitted as an emergency on 1st March 2007 and discharged on 1st May 2007, this would count as an emergency admission for the financial year ending 31st March 2008.

Multiple Emergency Admissions

If a patient has more than one unplanned continuous spell of treatment in hospital in a year, this is defined as a multiple emergency admission for that patient.

If one patient has 2 emergency continuous spells of care in hospital in a year and another patient has 10 emergency spells of hospital care in the same year, then they would simply count as 2 patients with multiple emergency admissions.

  • If a patient was admitted as an emergency on 1st December 2007 and discharged on 20th December 2007, admitted again on 1st February 2008 and discharged on 15th February 2008, this patient would count as one patient with multiple emergency admissions for the financial year ending 31st March 2008.
  • If a patient was admitted as an emergency on 1st December 2007 and discharged on 20th December 2007, admitted again on 1st February 2008 and discharged on 15th February 2008, and then admitted on 1st March 2008 and discharged on 2nd April 2008 with no further admissions this patient would count as a patient with multiple emergency admissions (two) for the financial year ending 31st March 2008 and a single emergency admission for the financial year ending 31st March 2009.

It is important to note that since information is shown for different geographical levels of analysis (e.g. NHS Board, Local Authority and Community Health Partnership) it is likely that the data may show some inconsistencies, for example, patients who are counted in different CHPs may only be counted once for the NHS Board.

  • If a patient had 4 emergency admissions within NHS Lothian but 2 were in West Lothian CHP and 2 were in Midlothian CHP because the patient moved house, these would be counted as a patient with a multiple emergency admission in West Lothian CHP and a patient with a multiple emergency admission in Midlothian CHP, but only as one patient with a multiple admission for NHS Lothian.

Bed Days

Occupied bed days are used to quantify the availability and use of beds over time.  These are calculated by counting the number of days between the date of admission associated with the beginning of a patient's continuous spell of treatment and the date of discharge associated with the end of the same spell of treatment.

The date of discharge must lie between 1st April and 31st March of a given financial year to calculate the number of bed days associated with emergency admissions in that year.

Only emergency admissions with a length of stay of 365 days or less are included in the bed days analysis.

  • If a patient was admitted on 1st June 2006 for an emergency operation for a Heart Bypass in Cardiac Surgery specialty, and transferred from that specialty to Rehabilitation Medicine on 1st July 2006, and then subsequently discharged from Rehabilitation Medicine on 31st July 2006, this would count as a single emergency admission in the year ending 31st March 2007.  The total number of occupied bed days for this emergency admission would be calculated from 1st June 2006 to 31st July 2006 (60 days).

Alternatively,

  • If a patient was admitted on 1st March 2007 for an emergency operation for a Heart Bypass in Cardiac Surgery specialty, and transferred from that specialty to Rehabilitation Medicine on 15th March 2007, and then subsequently discharged from Rehabilitation Medicine on 1st April 2007, this would count as a single emergency admission in the year ending 31st March 2008. The total number of occupied bed days for this emergency admission would be calculated from 1st March 2007 to 1st April 2007 (30 days).

For any further queries regarding this methodology, please contact nss.isdSCT@nhs.net


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