Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC)

Herbert, Annie; Wijlaars, Linda; Zylbersztejn, Ania; Cromwell, David; Hardelid, Pia

doi:10.1093/ije/dyx015

Cited by 480 publications

(564 citation statements)

References 45 publications

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“…This is linked to Hospital Episode Statistics (HES), routine administrative data collected by all National Health Service (NHS) hospitals in the UK [24]. Population denominator data were taken from Office of National Statistics mid-year estimates [25].…”

Section: Methodsmentioning

confidence: 99%

Spatial patterning of self-harm rates within urban areas

Polling

Bakolis

Hotopf

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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PurposeUrban areas are usually found to have higher rates of self-harm, with deprivation the strongest predictor at area-level. We use a disease mapping approach to examine how self-harm is patterned within an urban area and its associations with deprivation, urbanness and ethnicity.MethodsData from clinical records on individuals admitted for self-harm for 725 small areas in South East London were included. Bayesian hierarchical models explored the spatio-temporal patterns of self-harm admission rates and potential associations with proximity to city centre, population density, percentage greenspace and non-white ethnic-minority populations. All models were adjusted for area-level deprivation, social fragmentation and hospital of admission.ResultsThere were 8327 first admissions for self-harm during the study period. Self-harm admission rates varied fourfold across the study area, with lower rates close to the city centre [adjusted standardised admission ratio, closest versus furthest quartile 0.71(95% CrI 0.54–0.96)]. Deprivation was associated with self-harm but partially masked rather than explained the spatial pattern, which strengthened after adjustment. After adjustment for deprivation, hospital of admission and social fragmentation, greenspace, population density and ethnicity were not associated with self-harm rates.ConclusionProximity to the city centre was associated with lower rates of self-harm, but the usual operationalisations of urbanness, population density and greenspace, were not. Deprivation did not explain the spatial patterning, nor did ethnicity. While nationally self-harm rates are higher in urban and deprived areas, this cannot be extrapolated to mean that within cities the inner-city is the highest risk area nor that risk will be principally patterned according to deprivation.Electronic supplementary materialThe online version of this article (10.1007/s00127-018-1601-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Spatial patterning of self-harm rates within urban areas

Polling

Bakolis

Hotopf

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

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“…Hospital Episode Statistics (HES) contains routine records on clinical care (eg, date of beginning and end of each episode, main and other diagnoses, surgical procedures, etc.) of in‐patient stays at National Health Service hospitals in England . Dates and the nature of clinical care received by each patient are recorded in medical notes by the medical team and coded at the end of each episode to become part of the data.…”

Section: Methodsmentioning

confidence: 99%

The risk of venous thromboembolism during and after hospitalisation in patients with inflammatory bowel disease activity

Chu

Grainge

Card

2018

Aliment Pharmacol Ther

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Summary Background Inflammatory bowel disease (IBD) increases the risk of venous thromboembolism. Aims To determine when patients are at high risk of thromboembolic events, including after major surgery, and to guide timing of thromboprophylaxis. Methods Each IBD patient from Clinical Practice Research Datalink, linked with Hospital Episode Statistics, was matched to up to five non‐IBD patients in this cohort study. We examined their risk of thromboembolism in hospital and within 6 weeks after leaving hospital, with or without undergoing major surgery, and while ambulant. Hazard ratios were estimated using Cox regression, with adjustment for age, sex, body mass index, smoking and history of malignancy or thromboembolism. Results Overall 23 046 IBD patients had a thromboembolic risk 1.74‐times (95% CI = 1.55‐1.96) higher than 106 795 non‐IBD patients. Among ambulant patients, the thromboembolic risk was raised during acute (hazard ratio = 3.94, 2.79‐5.57) or chronic disease activity (3.97, 2.90‐5.45) but their absolute risk remained below 5/1000 person‐years. The hazard ratio for thromboembolism among in‐patients not undergoing major surgery was 1.13 (0.63‐2.02), compared to 2.43 (1.20‐4.92) among surgical patients, with a near doubling of absolute risk associated with surgery (59.5/1000 person‐years, compared with 31.1 without surgery). The absolute risk remained elevated within 6 weeks after leaving hospital (18.6/1000 person‐years in IBD patients after surgery). Conclusions IBD patients are at an increased risk of venous thromboembolism. Absolute risks are raised during active disease, when in hospital, and after leaving hospital following major surgery.

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“…The Hospital Episode Statistics Database11 is an administrative database with details of all admissions, outpatient appointments and accident and emergencies attendances at National Health Service hospitals in England from 1997 and onwards. The English healthcare system is a free tax-based system with the National Health Service hospitals covering the vast majority of public hospitals in England.…”

Section: Methodsmentioning

confidence: 99%

Surgical and percutaneous pulmonary valve replacement in England over the past two decades

Larsen

Dimopoulos

Uebing

et al. 2019

Heart

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ObjectivePulmonary valve replacement (PVR) is often required in patients with congenital heart disease. We aimed to describe temporal trends in PVR in a nationwide English cohort between 1997 and 2014, survival and the need for re-PVR.MethodsPatients were identified in the Hospital Episode Statistics Database. Survival data were retrieved from the UK Office for National Statistics.ResultsA total of 2733 patients underwent PVR (2845 procedures) over the study period. Median age at first procedure increased from 20.1 years in 1997–2005 to 24.7 years in 2006–2014. The annual number of PVRs increased from 23 in 1997 to 251 in 2014. Homografts were the most common choice in the early years, but the use of xenografts increased after 2005. During a median follow-up of 5.8 years, 176 patients died and 108 required redo PVR. Early (30 day) survival was 98% for all PVRs and was similar for all types of prostheses but longer-term mortality dropped to 92% at 10 years and 90% at 15 years. Age >16 years and percutaneous PVR were risk factors for death. The cumulative incidence for re-PVR at 10 years was 8% for all PVRs and 11% at 15 years. Risk factors for re-PVR were complex diagnosis, male gender and black ethnicity.ConclusionThere was a significant increase in the number of PVRs performed in England over the last two decades and a significant change in the type of prosthesis employed. While early mortality was low across the board, longer-term mortality was not negligible in this young population.

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Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC)

Cited by 480 publications

References 45 publications

Spatial patterning of self-harm rates within urban areas

Spatial patterning of self-harm rates within urban areas

The risk of venous thromboembolism during and after hospitalisation in patients with inflammatory bowel disease activity

Surgical and percutaneous pulmonary valve replacement in England over the past two decades

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