Hospital Episode Statistics
Introduction and Precis
In the UK National Health Service (NHS), every time an individual is admitted to hospital a standard set of data is collected and centrally reported to the NHS information Centre (NHS.IC). This information records certain demographic data items, such as age, sex and resident area, plus clinical information such as admission and discharge dates, recorded alongside how they came to be admitted and by what route and how they were discharged from hospital. All of the clinical information concerning diagnosis, complications and coexisting disorders is coded using the International Classification of Diseases (ICD) version 10, which has been used since 1996. For data concerning interventions and procedures then the Office of Population Census and Surveys (OPCS) version 4.4 coding system is used.
Each month this data is centralised to regional offices across the UK, which are currently the strategic health authorities. Subsequently it is centralised to allow rapid access to reasonably current NHS data. This data is available through the Secondary Uses Service (SUS) but is more complex to analyse as it has not been put through the rigorous data cleaning and testing processes that the NHS uses for its separately centralised annual returns. The uncleaned monthly returns is what is typically used by external third-party companies such as Dr Foster Intelligence and CHKS for their various forms of analysis, which they then sell back to NHS hospitals.
It is this annual return that is used to contribute to the National Burn Injury Database. This means that at the end of each financial year in March, several months of analysis and cleaning by the NHS.IC needs to be done before it is available. Analysis of the cleaned HES data offers greater accuracy and reproducibility but takes a greater time for it to be available.
Applications for HES data can be made by staff working in the health service but there are stringent confidentiality and security requirements to be fulfilled and confirmed before data can be released. This is especially so if the data has the potential for identifying rare health events that might be reported in the media. This clearly pertains to burn injury which are often associated with reported events in the media such as house fires, road traffic accidents etc. As a consequence, the storage, analysis and reporting of this data has to be carefully handled.
The benefits of this type of information when studying burn injury is that admissions to all hospitals, rather than just to the specialised burn services themselves are recorded. This provides less detailed information than iBID, but gives a better overview and perspective of the problem.
A more detailed description of this subject will soon be available ().