Data Sources
Hospital Admissions
Routine data by cause are collected on patients who are admitted
to hospital (in-patients). There are no routine data by cause
on out-patients or on A&E attendances. Information on health
service use from all causes is available from the Department of
Health for in-patients, out-patients and A&E, though LAIA
does not hold this type of data.
England - Hospital Episode Statistics (HES)
Hospital admissions in England have been recorded using the Hospital
Episode Statistics (HES) system since April 1987; previously they
were recorded under the HIPE system (see factsheet 96/2).
Under the HES system, discharges (and deaths) are identified
as Finished Consultant Episodes (FCE). A FCE is a period of care
under one consultant and patients may experience more than one
FCE in a single admission. LAIA data use the first episode, which
represents the admitting diagnosis.
HES data is presented in financial years, from March to April.
From April 1987 to March 1995 diagnoses in HES were classified
using the WHO International Classification of Diseases, 9th revision
(ICD 9). From the financial year beginning April 1995 onwards
these were classified using ICD 10.
Department
of Health (England): Hospital Episode Statistics.
Scotland
In Scotland, data have been collected as primary discharges from
inpatient and day case episodes in general and acute wards since
1968 and are now included as part of the Scottish Morbidity Record
(SMR1). Data are collected in calendar years. Diagnoses were classified
using ICD9 from 1980 to 1996 and ICD10 thereafter.
Information
Statistics Division (Scotland)
Wales
Admissions data have been collected separately for Wales since
1982. Admissions are held as part of the National Databases in
Wales.
Health Solutions
Wales
Northern Ireland
In NI discharges and deaths are recorded on the Hospital Inpatients
System.
DHSSPS
Northern Ireland
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Mortality
England & Wales
National Statistics produces annual routine statistics on numbers
of deaths by cause in England and Wales.
Deaths were coded using the WHO International Classification
of Diseases, 9th revision (ICD 9) from 1979 to 2000, and ICD10
thereafter. In addition, in this period there have been four changes
in the coding of causes of death. In 1979, a coding rule was abolished
which lead to an increase of 28% in the number of deaths attributed
to asthma (see factsheet 97/3). In 1983, the reinterpretation
of coding Rule 3 (regarding the main cause of death) led to decreases
in deaths from pneumonia and increases in deaths from certain
other causes, including asthma, particularly in the older age
groups. In 1992, Rule 3 reverted to its pre-1984 interpretation.
In 2001 ICD10 was introduced and also Rule 3 reverted back to
a definition similar to that used during 1984-1992. This has lead
to decreases in deaths from pneumonia and increases in other chronic
diseases once again, particularly in the older ages.
National
Statistics Online
Scotland
Deaths in Scotland are recorded by the General Register Office
for Scotland. Causes of death are coded using WHO International
Classification of Diseases, 9th revision (ICD 9)
The
General Register Office for Scotland
Northern Ireland
Deaths in Northern Ireland are recorded by the General Register
Office for Northern Ireland and are obtained from the Northern
Ireland Statistics and Research Agency (NISRA).
The Northern
Ireland Statistics and Research Agency (NISRA)
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GP Consultations
General Practice Research Database (GPRD)
A large national database of GP medical data collected from a
panel of general practices spread throughout England and Wales.
The database holds anonymised individual patient data for over
3.5 million patients. The practices are broadly representative
of the England and Wales population though smaller practices and
inner London practices are under-represented.
Key Health Statistics from General Practice 1998. Office for
National Statistics (2000). Series MB6 No.2. The Stationary Office.
National
Statistics Online
Morbidity Statistics from General Practice (MSGP)
The Morbidity Statistics from General Practice were a decennial
series of surveys of general practice from 1958 to 1991. The Fourth
National Survey of General Practice (MSGP4) was a survey of 60
general practices in England and Wales in 1991/92 covering a 1%
sample of the population (over 500,000 patients). Consultations
to GPs were recorded using ICD 9 codes and further socio-economic
data were recorded by trained interviewers. No more are planned
in this series.
Morbidity Statistics from General Practice 1991-92, Office for
National Statistics. Series MB5 no.3
Quality and Outcomes Framework (QOF)
The Quality and Outcomes Framework (QOF) is part of the new General Medical Services contract for general practices introduced in 2004. The QOF provides financial rewards to general practices for the provision of high quality care. The source of QOF published tables is the Quality Management and Analysis System (QMAS), a national IT system that supports the QOF payment process. Detailed QOF information for England, derived from QMAS, is published by the Health and Social Care Information Centre.
We have written a report on using QOF to assess asthma prevalence.
National
Statistics Online
Weekly Returns Service (WRS)
The Weekly Returns Service has been collecting information on
episodes of disease presenting to general practitioners since
1967. Weekly episodes of disease are recorded from 72 practices
covering 600,000 registered patients in Great Britain. It gives
new and on-going episode by disease type. Results are collated
by the Royal College of General Practitioners Research Unit.
Royal College of General Practitioners, Birmingham Research Unit
Prescription cost analysis
Prescription Cost Analysis (PCA) data are based on information
obtained from prescriptions sent to the Prescription Pricing Authority
(PPA) for payment. PCA data were extended in January 1991 to cover
all prescriptions dispensed in the community, i.e. by community
pharmacists, appliance contractors, dispensing doctors, and items
personally administered by doctors. Prior to 1991 PCA was restricted
to prescriptions dispensed by community pharmacists and appliance
contractors only and based on a sample of 1 in 200 prescriptions.
General Medical Practitioners in England write the vast majority
of prescriptions included. Prescriptions written by dentists and
hospital doctors are also included provided that they were dispensed
in the community. Also included are prescriptions written in Wales,
Scotland, Northern Ireland and the Isle of Man but dispensed in
England. Prescriptions written in England but dispensed outside
England are not included. The data do not cover items dispensed
in hospital or on private prescriptions.
Department
of Health Prescription Statistics
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Surveys
Surveys of respiratory and allergic disease
International Survey of Asthma and Allergies in Childhood
(ISAAC)
Phase I of the International Study of Asthma and Allergies in
Childhood used a standardised protocol to obtain comparable international
prevalence data on the prevalence of asthma, hayfever and eczema
and their symptoms in 6-7 year olds and 13-14 year olds from 155
centres in 56 countries. Phase II involved more intensive studies
in a smaller number of selected centres and Phase III will examine
variations in time trends of asthma, allergic rhinoconjunctivitis
and atopic eczema around the world.
ISAAC
European Community Respiratory Health Survey (ECRHS)
The European Community Respiratory Health Survey used standardised
methods to sample over 150,000 adults aged 20-44 years in 40 areas
in 17 European countries. It contained questions on symptoms of
asthma and hayfever as well as specific IgE results.
ECRHS
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Health surveys
Health Survey for England
The Health Survey for England is an annual series of national
representative interview surveys of private households in England.
The Health Survey combines questionnaire answers and physical
measurements as well as other objective measures such as analysis
of blood samples and lung function tests.
The survey contains a 'core' which is repeated each year and
each survey year has one or more modules on subjects of special
interest. In 1995, 1996, 1997, 2001 and 2002 there were a series of
questions on respiratory health together with detailed questions
on socio-economic circumstances from approximately 40,000 children
and adults.
Department
of Health Health Survey for England
Scottish Health Survey
A series of national surveys of the Scottish population in private households.
Scottish
Executive Scottish Health Survey
Welsh Health Survey
A series of surveys of the Welsh population, collecting information on a range of illnesses.
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Other surveys
General Household Survey
Continuous survey of the population resident in private households
in Great Britain with questions on chronic sickness and smoking.
In 2001 the survey results were published in "Living in Britain".
National
Statistics Online
Other Data Sources
Health Protection
Agency (HPA)
This agency, created in April 2003, includes the functions of
the former Public Health Laboratory Service (PHLS) which incorporated
the Communicable Disease Surveillance Centre (CDSC). It holds
data on registered infections (including tuberculosis and respiratory
syncytial virus) and produces weekly mortality and morbidity reports.
Scotland
Notification data on infectious diseases for Scotland can be obtained from the
Information and Statistics Division Scotland through their website,
Scottish Health Statistics.
Scottish Health Statistics (ISD Scotland)
Northern Ireland
Notification data on infectious diseases for Northern
Ireland can be obtained from the Communicable Disease
Surveillance Centre in Northern
Ireland.
Communicable Disease Surveillance Centre Northern Ireland
(CDSC NI)
UK Transplant
UK Transplant is a Special Health Authority established in 1991.
It holds the National Transplant Database maintained on behalf
of transplant services in the UK and Ireland and publishes data
on lung and heart-lung transplants.
Cochrane
Airways Group
The Cochrane Collaboration is an international organisation that
was set up to prepare and disseminate systematic reviews of RCTs
in prevention and treatment in many different areas of health
care. The Cochrane Airways Group has reviewers in 21 countries
world-wide. The authors of the reviews are professionals from
medicine and allied disciplines. They receive support from the
editorial base and supervision from an international editorial
team of experts in respiratory medicine. Summaries of reviews
may be viewed on their web site.
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