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Patient Reported Outcome Measures (PROMs) in England - 2012-13, Special Topic, Directly Standardised Rates of Episodes

Publication date: 09:30 November 13, 2014

Summary

This PROMs special topic is based on the finalised data for April 2012 to March 2013, first published on 14th August 2014. Data are presented by Clinical Commissioning Group (CCG) of residence.

Rates of hospital admissions may vary greatly by age and sex, making  it more difficult to compare two areas that have differences in the age and sex makeup of their populations. Directly age- and sex-standardised rates adjust for this by showing the rate of PROMs-eligible hospital episodes that would occur in a standard population if it were to experience the age- and sex-specific rates of episodes for a given area. This means that areas with different age and sex makeups can be compared directly, with the rates having been adjusted for these factors.

The standard population used in this analysis is the 2013 European Standard Population. This population is used for males, females, and persons, which means that rates can be compared across gender but also that rates for persons are standardised for age only, and not for sex.


Key Facts

  • Direct age- and sex-standardisation attempts to adjust for differences between the age and sex makeup of organisations' populations. This analysis does not adjust for other potentially confounding factors; case-mix adjusted data can be viewed in the Score Comparison Tool spreadsheet that accompanies full PROMs publications, found at www.hscic.gov.uk/proms.
  • For groin hernia episodes, there are relatively small differences between the crude and standardised rates. In general, standardised rates of hospital episodes are lower than their corresponding crude rates in parts of Yorkshire, Cheshire, and the south coast. This indicates that the comparatively older age structure of these areas' populations is affecting the number of hospital admissions for this procedure. Conversely, London and the midlands - which have comparatively younger populations - have slightly higher standardised rates than crude rates. As groin hernia procedures are most common amongst older age groups, this indicates that these areas have fewer episodes largely because of the age of their populations.
  • For hip replacement episodes, there are several areas with lower standardised rates than the corresponding crude rates; particularly in parts of the north-west and the central south coast. This indicates that the comparatively older age structure of these areas' populations is affecting the number of hospital admissions for this procedure. Conversely, parts of the central south east and the east of England - which have comparatively younger populations - have higher standardised rates than crude rates. As hip replacement procedures are most common amongst older age groups, this indicates that this area has fewer episodes largely because of the age of its population.
  • For knee replacement episodes, there are a number of areas with lower standardised rates than their corresponding crude rates; particularly in parts of the north west, North Yorkshire, East Anglia, the south west, and the central south coast. This indicates that the comparatively older age structure of these areas' populations is affecting the number of hospital admissions for this procedure. Conversely, London, Northamptonshire, Cambridgeshire, and West Yorkshire - which have comparatively younger populations - have higher standardised rates than crude rates. As knee replacement procedures are most common amongst older age groups, this indicates that these areas have fewer episodes largely because of the age of their populations.
  • For varicose vein episodes, there are relatively small differences between the crude and standardised rates of episodes for people undergoing varicose vein procedures. Broadly, the crude rates are similar to the directly standardised rates, which indicates that the age makeup of populations does not have a significant impact on the number of hospital episodes for varicose veins. The spread of varicose vein procedures across a wide range of age groups further supports this.

Coverage

Date Range: 01 April 2012 to 31 March 2013
Geographical coverage: England
Geographical granularity: Country, NHS Trusts, Hospital Trusts, Independent Sector Health Care Providers, Clinical Commissioning Groups

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