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* The technical term for what has been supplied is finished admission episodes.
Assignment of Episodes to Years
Years are assigned by the end of the first period of care in a patients hospital stay.
Finished admission episodes
A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
Cause codestab wounds** and gunshot wounds***
The cause code is a supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects.
Hospital Episode Statistics (HES) has used the following ICD-10 external cause codes when referring to gunshot wounds and knife-related injuries.
** Stab wounds:
X99.Assault by sharp object
*** Gunshot wounds:
W33.Rifle, shotgun and larger firearm discharge
W34.Discharge from other and unspecified firearms
X72.Intentional self-harm by handgun discharge
X73.Intentional self-harm by rifle, shotgun and larger firearm discharge
X74.Intentional self-harm by other and unspecified firearm discharge
X93.Assault by handgun discharge
X94.Assault by rifle, shotgun and larger firearm discharge
X95.Assault by other and unspecified firearm discharge
Y22.Handgun discharge, undetermined intent
Y23.Rifle, shotgun and larger firearm discharge, undetermined intent
Y24.Other and unspecified firearm discharge, undetermined intent
Y35.0 Legal intervention involving firearm discharge
Y36.4 War operations involving firearm discharge and other forms of conventional warfare
HES are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.
Assessing growth through time
HES figures are available from 1989-90 onwards. During the years that these records have been collected, the NHS there have seen ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in out-patient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
Due to reasons of confidentiality, figures between 1 and 5 have been suppressed and replaced with * (an asterisk).
PCT and SHA Data Quality
PCT and SHA data was added to historic data-years in the HES database using 2002-03 boundaries, as a one-off exercise in 2004. The quality of the data on PCT of Treatment and SHA of Treatment is poor in 1996-97, 1997-98 and 1998-99, with over a third of all finished episodes having missing values in these years. Data quality of PCT of general practitioner (GP) practice and SHA of GP practice in 1997-98 and 1998-99 is also poor, with a high proportion missing values where practices changed or ceased to exist. There is less change in completeness of the residence-based fields over time, where the majority of unknown values are due to missing postcodes on birth episodes. Users of time series analysis including these years need to be aware of these issues in their interpretation of the data.
HES, The NHS Information Centre for health and social care.
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