Pneumococcal Disease

(asked on 17th March 2015) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the average (a) length and (b) cost was of a hospital admission owing to a case of pneumococcal disease in the last 12 months.


Answered by
 Portrait
Jane Ellison
This question was answered on 24th March 2015

The data requested is provided in the following table.

Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector

Diagnosis

Mean1 Length of Stay2

Median1 Length of Stay2

Number of observations (denominator)1

Finished Admission Episodes

Critical care periods

Pneumonia

10.6

6

220,130

192,106

13,776

Pneumococcal Infection

12.4

8

4,379

3,792

986


Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

Data relating to the cost of a hospital admission due to a case of pneumococcal disease are not available. However, the cost of a hospital admission due to bronchopneumonia is estimated to be £3,293 per hospital spell.

Source: estimates drawn from NHS reference costs:

https://www.gov.uk/government/publications/nhs-reference-costs-2013-to-2014

Notes:

1 Mean, median and denominator The mean (average) and median (middle in ranking when all values are sorted in order) duration in days between the admission and discharge dates. The Health and Social Care Information Centre (HSCIC) has displayed the denominator from which the averages are calculated and note that it is greater than the count of admission episodes. This is because episodes are reported against the year in which they finish, i.e. some discharge episodes relate to admissions prior to 2013-14, and some admission episodes relate to care which continues after 2013-14; and it is also the case that diagnoses are recorded independently on each episode of care.

2 Length of Stay (duration of spell) The difference in days between the admission date and the episode end date (duration of episode) or discharge date (duration of spell), where both dates are given. Length of Stay is based on hospital stays and only applies to ordinary admissions not day cases (unless otherwise stated). Information relating to Length of Stay, including discharge method/destination, diagnoses and any operative procedures, is based only on the final episode of the spell.

A: Primary Diagnosis The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.

B: ICD10 codes: Pneumonia and Pneumococcal Infection Pneumonia: B20.6 HIV disease resulting in Pneumocystis jirovecii pneumonia, J09.X Influenza due to identified avian influenza virus, J10.0 Influenza with pneumonia, other influenza virus identified, J11.0 Influenza with pneumonia, virus not identified, J12.- Viral pneumonia, not elsewhere classified, J13.X Pneumonia due to Streptococcus pneumonia, J14.X Pneumonia due to Haemophilus influenza, J15.- Bacterial pneumonia, not elsewhere classified, J16.- Pneumonia due to other infectious organisms, not elsewhere classified, J17.-A Pneumonia in diseases classified elsewhere, J18.- Pneumonia, organism unspecified, J85.1 Abscess of lung with pneumonia P23.- Congenital pneumonia. Pneumococcal Infection: A40.3 Sepsis due to Streptococcus pneumonia, G00.1 Pneumococcal meningitis, J13.X Pneumonia due to Streptococcus pneumonia, M00.1 Pneumococcal arthritis and polyarthritis, B95.3 Streptococcus pneumoniae as the cause of diseases classified to other chapters, B95.3 is a supplementary code and would only be found in a secondary position. It indicates Streptococcus pneumoniae as the cause of another disease classified to another chapter within ICD-10. Note that code J13X is included in the definition of both pneumonia and pneumococcal infections.

C: Data are not available to cover accident and emergency (A&E) admission related to (i) pneumonia and (ii) pneumococcal disease in the last 12 months because the HES A&E dataset contains a limited amount of information regarding diagnosis and therefore does not identify pneumonia and pneumococcal infections separately.

D: The answer to PQ227934 is based on the final episode of the spell in order to calculate the length of stay. Therefore the number of observations (denominator) is not comparable to the count of admission episodes in the response to PQ227933 as admissions are based on the first episode of the spell.

In addition, note that the answer to PQ227935 is limited to adult critical care periods, which include periods of care in high dependency and intensive care units.

E: A finished admission episode (FAE) is the first period of admitted patient care under one consultant within one healthcare provider whereas a finished discharge episode (FDE) is the last episode during a hospital stay (a spell), where the patient is discharged from the hospital or transferred to another hospital. FDEs must be used in order to calculate the length of the patient’s stay in hospital. Neither FAEs or FDEs represent a count of patients as a person may have had more than one admission or discharge from hospital within the time period.

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