B Health impact of drug misuse
B1 Hospital Discharges
Key Points 2005/06
Overview
- During 2005/06 there were 5,015 general acute hospital discharges with a diagnosis (main or supplementary) of drug misuse, a rate of 102 discharges per 100,000 population (Table B1.1).
- Over two-thirds of the discharges were men (3,515) (Table B1.1).
- Those aged 25 to 29 years had the highest rate of discharges, with 323 discharges per 100,000 population (Table B1.1).
- Nearly 80% of discharges had been admitted as an emergency rather than an elective (i.e. planned) intake (3,916). The likelihood of an elective intake increased with age, with around a third of those aged over 50 being admitted as an elective case (Table B1.4).
- Over half of all cases were discharged from the specialty of general medicine. A further 8% were discharged from orthopaedics and 6% from general surgery (Table B1.5).
- Nearly 90% of cases (4,472) involved a stay of less than a week (Table B1.6).
Five year trends — 2001/02 to 2005/06
- Between 2001/02 and 2004/05 the rate of discharges involving drug misuse increased from 101 discharges per 100,000 population to 109 per 100,000. It then decreased to 102 discharges per 100,000 population in 2005/06 (Table B1.1).
- The proportion of discharges involving drug misuse where the patient was aged 30 years and over has increased. Those aged 30 years and over accounted for 48% of discharges in 2001/02 and 60% by 2005/06 (Table B1.1).
- Between 2001/02 and 2005/06 all age groups 30 years and over have seen an increase in the rate per 100,000 population while, for all age groups under 30 years there were decreases in the rate per 100,000 population (Table B1.1).
- The proportions of male and female discharges have remained stable over the five year period with males accounting for 70% of discharges (Table B1.1).
Drugs recorded
- Opioids were recorded in around two-thirds of discharges involving drug misuse (3,111). Cannabinoids were the next most frequently recorded drug (661) (Table B1.2).
- The type of drug involved varied with age. For those aged under 20 years cannabinoids were recorded in around 40% of cases while for those aged 20 years and over it was recorded in only 11% of cases. Opioids were recording in 21% of cases for those aged under 20 years but in 65% of cases for those aged 20 years and over (Table B1.2).
Geographical profile
- The rate of drug misuse discharges varied considerably across Scotland in 2005/06 with the highest levels being seen in NHS Ayrshire and Arran (193 discharges per 100,000 population), NHS Greater Glasgow (136 discharges per 100,000 population) and NHS Fife (135 discharges per 100,000 population). The lowest rates were in NHS Orkney (6 discharges per 100,000 population and NHS Forth Valley (37 discharges per 100,000 population) (Table B1.1).
- The majority of NHS board areas saw a rise in discharges with a diagnosis of drug misuse between 2001/02 and 2005/06. The largest increases were seen in NHS Shetland which saw an increase from 28 to 109 discharges per 100,000 population over the five years and in NHS Fife which increased from 72 to 135 discharge per 100,000 population. Some boards did see decreases, with the largest decreases seen in NHS Greater Glasgow decreasing from 203 to 136 discharges per 100,000 population over the five years and NHS Dumfries and Galloway decreasing from 112 to 74 discharges per 100,000 population (Table B1.1).
Background information
Data on individual patients are collected by ISD Scotland as a series of Scottish Morbidity Records (SMR).
The SMR datasets are a significant local and national information resource, and are used for epidemiological monitoring, health needs assessment, national and local planning and a range of other applications.
SMR01 is an episode based patient record relating to all inpatients and day cases discharged from specialities other than mental health, maternity, neonatal and geriatric long stay specialities in the NHS Scotland. A record is generated for each inpatient and day case episode, of which there are about 1,200,000 each year. Attendances at Accident and Emergency that do not result in an admission are not included. Each individual patient may have more than one episode and hence the number of people discharged within a year will be less than the total number of discharges. The SMR01 basic data set encompasses patient identification and demographic information, episode management information and general clinical information. Items such as waiting time for inpatient or day case admission and length of stay may be derived from the episode management information.
The tables presented here are derived from the SMR01, and contain information about patients admitted to general hospitals (mainly for emergency treatment), where drugs misuse is diagnosed as a factor in the patient’s treatment. Up to six diagnoses are recorded per admission, and episodes with either a main or a supplementary diagnosis of drugs misuse are included. Poisonings and overdoses are not included unless a diagnosis of drug misuse is also recorded. In the tables of drug type (B1.2, B1.3 and B1.7), there is an element of double counting as episodes may be associated with, for example, diagnoses of both opiate and cocaine misuse. Drugs misuse is recorded using the International Classification of Diseases 10th Revision (ICD10) Codes. The following codes were used in the analysis presented in this section:
ICD 10 Code |
Description |
F11 |
Opioids |
F12 |
Cannabinoids |
F13 |
Sedatives / Hypnotics |
F14 |
Cocaine |
F15 |
Other Stimulants |
F16 |
Hallucinogens |
F18 |
Volatile Solvents |
F19 |
Multiple / Other Psychoactive Substances |
Some caution is necessary when using these data as (a) drug misuse may only be suspected and may not always be recorded by the hospital, and (b) where drug misuse is recorded, it may not be possible to identify which drug(s) may be involved.
Further information
Information on ISD Scotland’s national datasets can be found on our website at: http://www.isdscotland.org/what_data_are_collected
Further statistics on general acute hospital discharges are available at: http://www.isdscotland.org/acute_hospital_care
If you would like further information on hospital discharges relating to drug misuse then please contact the Substance Misuse Information Strategy Team at substancemisuse@isd.csa.scot.nhs.uk.
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