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Falls Analysis Fragility Fractures for patients aged 50 years and over (Using SEPHO ICD10 diagnosis definition) Draft v0.1 19 March 2011.

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Presentation on theme: "Falls Analysis Fragility Fractures for patients aged 50 years and over (Using SEPHO ICD10 diagnosis definition) Draft v0.1 19 March 2011."— Presentation transcript:

1 Falls Analysis Fragility Fractures for patients aged 50 years and over (Using SEPHO ICD10 diagnosis definition) Draft v0.1 19 March 2011

2 Falls Analyses Contents: o F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust o F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust o F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level 2

3 F1.1.1(3) - In hospital mortality for people admitted with fragility fracture, by acute trust 3

4 F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust Table 1a: Observed number of deaths for for people admitted with fragility fracture (2008/09) Data source: HES 2008/09, 2009/10 4 Table 1b: Observed number of deaths for for people admitted with fragility fracture (2009/10) CodeProvider Name 2008/09 Q12008/09 Q22008/09 Q32008/09 Q42008/09 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST37131639 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST1113171354 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST9813838 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST111413846 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST2313251677 RTRSOUTH TEES HOSPITALS NHS TRUST7513934 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST7414530 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST117121343 NORTH EAST827112088361 CodeProvider Name 2009/10 Q12009/10 Q22009/10 Q32009/10 Q42009/10 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST16611538 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST1630171073 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST13881241 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST567826 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST2517251885 RTRSOUTH TEES HOSPITALS NHS TRUST14313838 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST696930 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST5811529 NORTH EAST100879875360

5 5 Data source: HES 2008/09 Chart 1a: Standardised Mortality Ratio for people admitted with fragility fracture and 95% confidence intervals (2008/09) F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust

6 6 Data source: HES 2009/10 Chart 1b: Standardised Mortality Ratio for people admitted with fragility fracture and 95% confidence intervals (2009/10) F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust

7 7 Data source: HES 2008/09 Chart 2a: Funnel plot for SMR of people admitted with fragility fracture with 95% and 99.8% control limits (2008/09) F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust

8 8 Data source: HES 2009/10 Chart 2b: Funnel plot for SMR of people admitted with fragility fracture with 95% and 99.8% control limits (2009/10) F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust

9 F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust 9

10 Table 1a: Observed number of secondary care admissions with fragility fracture (2008/09) Data source: HES 2008/09, 2009/10 10 Table 1b: Observed number of secondary care admissions with fragility fracture (2009/10) CodeProvider Name 2008/09 Q12008/09 Q22008/09 Q32008/09 Q42008/09 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST174183234163754 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST3113103732591253 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST130121177119547 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST160157214133664 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST3363434082871374 RTRSOUTH TEES HOSPITALS NHS TRUST230233256230949 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST988611152347 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST194205259177835 NORTH EAST16331638203214206723 CodeProvider Name 2009/10 Q12009/10 Q22009/10 Q32009/10 Q42009/10 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST209205237194845 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST3233193542981294 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST127134183133577 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST159181209158707 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST3263714203081425 RTRSOUTH TEES HOSPITALS NHS TRUST255205307201968 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST928991110382 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST195206231175807 NORTH EAST16861710203215777005

11 F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust Table 1a: Indirectly Standardised Ratio of secondary care admissions with fragility fracture (2008/09) Data source: HES 2008/09, 2009/10 11 Table 1b: Indirectly Standardised Ratio of secondary care admissions with fragility fracture (2009/10) CodeProvider Name 2008/09 Q12008/09 Q22008/09 Q32008/09 Q42008/09 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST7679927280 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST132133141119132 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST163150199158168 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST10610813096111 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST132139149128138 RTRSOUTH TEES HOSPITALS NHS TRUST8385899488 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST13912714992129 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST6063756065 CodeProvider Name 2009/10 Q12009/10 Q22009/10 Q32009/10 Q42009/10 RLNCITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST8382837982 RXPCOUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST134130121122127 RR7GATESHEAD HEALTH NHS FOUNDATION TRUST146162178157162 RVWNORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST100118114102109 RTFNORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST125144138127134 RTRSOUTH TEES HOSPITALS NHS TRUST9376977184 RE9SOUTH TYNESIDE NHS FOUNDATION TRUST128124110159129 RTDTHE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST6163625360

12 12 Data source: HES 2008/09 Chart 1a: Indirectly Standardised Ratio of secondary care admissions with fragility fracture and 95% confidence intervals (2008/09) F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust

13 13 Data source: HES 2009/10 Chart 1a: Indirectly Standardised Ratio of secondary care admissions with fragility fracture and 95% confidence intervals (2009/10) F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust

14 14 Data source: HES 2008/09 Chart 1a: Funnel plot for secondary care admissions with fragility fracture with 95% and 99.8% control limits (2008/09) F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust

15 15 Data source: HES 2009/10 Chart 1b: Funnel plot for secondary care admissions with fragility fracture with 95% and 99.8% control limits (2009/10) F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust

16 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level 16

17 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level Table 1a: Observed number of secondary care admissions with fragility fracture (2008/09) Data source: HES 2008/09 17 CodePCT Name 2008/09 Q12008/09 Q22008/09 Q32008/09 Q42008/09 5NDCOUNTY DURHAM PCT3212934002441258 5J9DARLINGTON PCT53656856242 5KFGATESHEAD PCT123115186109533 5D9HARTLEPOOL PCT44486245199 5KMMIDDLESBROUGH PCT77688779311 5D7NEWCASTLE PCT153144178132607 5D8NORTH TYNESIDE PCT154163187128632 TACNORTHUMBERLAND CARE TRUST208218265188879 5QRREDCAR AND CLEVELAND PCT77 7678308 5KGSOUTH TYNESIDE PCT1028712058367 5E1STOCKTON-ON-TEES TEACHING PCT989911274383 5KLSUNDERLAND TEACHING PCT159181191155686 NORTH EAST15691558193213466405

18 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level Table 1b: Observed number of secondary care admissions with fragility fracture (2009/10) Data source: HES 2009/10 18 CodePCT Name 2009/10 Q12009/10 Q22009/10 Q32009/10 Q42009/10 5NDCOUNTY DURHAM PCT3373163642831300 5J9DARLINGTON PCT64656872269 5KFGATESHEAD PCT120132172128552 5D9HARTLEPOOL PCT49567256233 5KMMIDDLESBROUGH PCT827010564321 5D7NEWCASTLE PCT136147160125568 5D8NORTH TYNESIDE PCT163151192125631 TACNORTHUMBERLAND CARE TRUST199249274207929 5QRREDCAR AND CLEVELAND PCT907012490374 5KGSOUTH TYNESIDE PCT1019593119408 5E1STOCKTON-ON-TEES TEACHING PCT8510011182378 5KLSUNDERLAND TEACHING PCT186191220177774 NORTH EAST16121642195515286737

19 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level Table 2a Directly Standardised Rate of secondary care admissions with fragility fracture per 100,000 population per year (2008/09) Data source: HES 2008/09 19 CodePCT Name 2008/09 Q12008/09 Q22008/09 Q32008/09 Q42008/09 5NDCOUNTY DURHAM PCT536455664379508 5J9DARLINGTON PCT368513528513480 5KFGATESHEAD PCT484498798486567 5D9HARTLEPOOL PCT436479604427486 5KMMIDDLESBROUGH PCT487418578509498 5D7NEWCASTLE PCT557467596471523 5D8NORTH TYNESIDE PCT586641741529624 TACNORTHUMBERLAND CARE TRUST453490632470511 5QRREDCAR AND CLEVELAND PCT390414408459418 5KGSOUTH TYNESIDE PCT515491623324488 5E1STOCKTON-ON-TEES TEACHING PCT457443523366447 5KLSUNDERLAND TEACHING PCT491530600477524

20 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level Table 2b: Directly Standardised Rate of secondary care admissions with fragility fracture per 100,000 population per year (2009/10) Data source: HES 2009/10 20 CodePCT Name 2009/10 Q12009/10 Q22009/10 Q32009/10 Q42009/10 5NDCOUNTY DURHAM PCT532496581465518 5J9DARLINGTON PCT478540511568524 5KFGATESHEAD PCT500567735529583 5D9HARTLEPOOL PCT463534630562547 5KMMIDDLESBROUGH PCT523453701446531 5D7NEWCASTLE PCT440494546437479 5D8NORTH TYNESIDE PCT605575774515617 TACNORTHUMBERLAND CARE TRUST441564622485528 5QRREDCAR AND CLEVELAND PCT469388622455484 5KGSOUTH TYNESIDE PCT476432473582491 5E1STOCKTON-ON-TEES TEACHING PCT370494506404444 5KLSUNDERLAND TEACHING PCT530578703561593

21 21 Data source: HES 2008/09 and ONS 2008 population estimates Chart 1a: Directly Standardised Rate of secondary care admissions with fragility fracture per 100,000 population and 95% confidence intervals (2008/09) F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level

22 22 Data source: HES 2009/10 and ONS 2009 population estimates Chart 1b: Directly Standardised Rate of secondary care admissions with fragility fracture per 100,000 population and 95% confidence intervals (2009/10) F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level

23 23 Data source: HES 2008/09 & 2009/10 and ONS 2008 & 2009 population estimates Chart 2: Time Series of Directly Standardised Rate of secondary care admissions with fragility fracture per 100,000 population F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level

24 24 Data source: HES 2008/09 and ONS 2008 population estimates Chart 3a: Funnel plot of secondary care admissions with fragility fracture with 95% and 99.8% control limits (2008/09) F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level

25 25 Data source: HES 2009/10 and ONS 2009 population estimates Chart 3b: Funnel plot of secondary care admissions with fragility fracture with 95% and 99.8% control limits (2009/10) F1.2.3(3) – Rate of secondary care admissions with fragility fracture of the proximal femur, by acute trust

26 Data Specifications 26

27 ICD10 Codes for Fragility Fractures 27 M48.4Fatigue fracture of vertebraS42.2Fracture of upper end of humerus M48.5Collapsed vertebra, not elsewhere classifiedS42.3Fracture of shaft of humerus M80.0Postmenopausal osteoporosis with pathological fractureS42.4Fracture of lower end of humerus M80.1Postoophorectomy osteoporosis with pathological fractureS52.0Fracture of upper end of ulna M80.2Osteoporosis of disuse with pathological fractureS52.1Fracture of upper end of radius M80.3Postsurgical malabsorption osteoporosis with path fractureS52.2Fracture of shaft of ulna M80.4Drug-induced osteoporosis with pathological fractureS52.3Fracture of shaft of radius M80.5Idiopathic osteoporosis with pathological fractureS52.4Fracture of shafts of both ulna and radius M80.8Other osteoporosis with pathological fractureS52.5Fracture of lower end of radius M80.9Unspecified osteoporosis with pathological fractureS52.6Fracture of lower end of both ulna and radius S22.0Fracture of thoracic vertebraS52.7Multiple fractures of forearm S22.1Multiple fractures of thoracic spineS62.0Fracture of navicular [scaphoid] bone of hand S32.0Fracture of lumbar vertebraS72.0Fracture of neck of femur S32.1Fracture of sacrumS72.1Pertrochanteric fracture S32.2 Fracture of coccyxS72.2Subtrochanteric fracture S32.3Fracture of iliumS72.3Fracture of shaft of femur S32.4Fracture of acetabulumT08.XFracture of spine, level unspecified S32.7Multiple fractures of lumbar spine and pelvis Data source: “Benchmarking quality of care for fragility fractures in the South Central SHA area”, October 2010, SEPHO.

28 F1.1.1(3) – In hospital mortality for people admitted with fragility fracture, by acute trust Data Source: HES data 2008/09, 2009/10 Data Details: Primary diagnosis recorded as fragility fracture for discharge episode (see ICD10 codes) Age at start of discharge episode greater or equal to 50 years old Admitted and discharged within year Discharge method equal to Death Indicator: Numerator: Number of secondary care admissions with fragility fracture where the patient died in hospital Denominator: All admissions with a primary diagnosis of fragility fracture Presentation: By acute trust Data Handling Notes: Indirectly standardised rate based on sex and age (5 year age bands from 50 to 89, and 90 and over) 28

29 F1.2.1(3) – Rate of secondary care admissions with fragility fracture, by acute trust Data Source: HES data 2008/09, 2009/10 Data Details: Primary diagnosis recorded as fragility fracture for discharge episode (see ICD10 codes) Age at start of discharge episode greater or equal to 50 years old Admitted and discharged within year Indicator: Numerator: Number of secondary care admissions with fragility fracture Denominator: All secondary care admissions Presentation: By acute trust Data Handling Notes: Indirectly standardised rate based on sex and age (5 year age bands from 50 to 89, and 90 and over ) 29

30 F1.2.2(3) – Standardised rate of secondary care admissions with fragility fracture, at a population level Data Source: HES data 2008/09, 2009/10 ONS population estimates 2008, 2009 Data Details: Primary diagnosis recorded as fragility fracture for discharge episode (see ICD10 codes) Age at start of discharge episode greater or equal to 50 years old Admitted and discharged within year Indicator: Numerator: Number of secondary care admissions with fragility fracture Denominator: PCT population Presentation: By PCT of residence Data Handling Notes: Directly standardised rate based on sex and age (5 year age bands from 50 to 84, and 85 and over) using WHO European standard age structure. 30

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