A&E admissions by diagnosis and SHA

Emergency admissions have been steadily increasing, rising by 29 per cent since 1997 and by 5 per cent year on year between 2004 and 2005 when they reached a total of 4,493,247. While emergency admissions increased, the number of bed days decreased by 6 per cent to 8,529,747.

In Q4 2005, non-specific chest pain and abdominal pain accounted for more than 50,000 emergency admissions each, representing an 8 per cent increase on the same quarter the previous year. Emergency admissions for other upper respiratory diseases increased by 22 per cent, from 17,969 in Q4 2004 to 21,838 in Q4 2005. Similarly, connective tissue disease saw a rise in emergency admissions from 14,533 to 16,674 and urinary tract infections rose from 20,591 to 23,402.

There was a decrease in emergency admissions between 2004 and 2005 for a number of diagnoses. Admissions for asthma were 20,231 in Q4 2004 compared to 18,724 in Q4 2005, a 7 per cent decrease. Smaller decreases were observed in other high-volume diagnoses - for example, coronary atherosclerosis (5 per cent) and chronic obstructive pulmonary disease (2 per cent).

Most strategic health authorities saw an increase in emergency admissions, averaging 4 per cent. The largest increase, at 13 per cent, was in North West London, up from 34,438 in Q4 2004 to 38,763 in Q4 2005. In North Central London the increase was 12 per cent from 26,033 to 29,185.

In contrast to a previous Data Briefing, where Avon, Gloucestershire and Wiltshire SHA experienced a decrease in emergency admissions, for Q4 2005 this SHA saw an increase in line with the national average.

There does not appear to be a link between emergency admissions and bed days. Across England there was a 5 per cent increase in emergency admissions and a 6 per cent decrease in bed days. There was a reduction in bed days for all SHAs, with the exception of Essex, where there was an increase of 1 per cent.

Admissions are based on the initial hospital to which people are reported ill and the date, where it is an emergency admission. Bed days are the number of days for patients whose initial spell followed an emergency admission. These figures include post-transfer bed days, some or all of which may have occurred in providers outside the initial SHA.

Dr Marc Farr is market development manager at Dr Foster Intelligence (phone 020-7256 4916 or visit www.drfoster.co.uk).