B2 Psychiatric discharges
These statistics are derived from data collected through the mental health inpatient and day case return (SMR04), which records information at admission and discharge. Data from NHS Fife for 2003/04 to 2004/05 and NHS Forth Valley for 2004/05 is not available at time of publication due to technical problems with data submission (see Background Information section for more information). Fife and Forth Valley are not included for 2004/05 (Tables B2.2 to B2.6).
National figures for 2000/01-2004/05 are presented in Table B2.1. These include figures for Scotland up to 2002/03 and for Scotland excluding Fife and Forth Valley. Statistics for NHS Board and council area are presented for Fife up to 2002/03 and for Forth Valley up to 2003/04. |
Key Points 2004/05
Overview
- In 2004/05 there were 25,924 psychiatric discharges in Scotland (excluding NHS Fife and NHS Forth Valley). 1,620 (6%) of which had a diagnosis of drug misuse (main or supplementary), a rate of 38 per 100,000 population (Tables B2.1 and B2.2).
- Of the 1,620 psychiatric discharges relating to drug misuse over two-thirds (1,128) were re-admissions (Table B2.1).
- Over two-thirds (1,067) of drug misuse discharges were males (Table B2.1).
- The majority, over two thirds, were aged under 35 years (68%). Only 1 case was under 15 years. The age group 25 to 29 years had the highest rate of discharges per 100,000 population, with 139 per 100,000 population (359) (Table B2.1).
- For the 931 discharges where drug misuse was the main diagnosis the majority (637) had no other diagnosis recorded (Tables B2.1 and B2.3).
- Where a main diagnosis of drug misuse was recorded with supplementary diagnoses, the most common supplementary diagnoses were mood (affective) disorders and personality disorders. It was also common for a further drug misuse code to be recorded. This additional drug misuse code most commonly referred to another type of drug but could also refer to a different problem resulting from the same drug (Table B2.3).
- Over a third (765) of discharges involved a supplementary diagnosis for drug misuse. In these cases the most common main diagnoses were schizophrenia and mood (affective) disorders (Table B2.4).
- Periods of hospitalisation are generally longer for psychiatric admissions than general hospital admissions, with 57% of drug misuse patients remaining in hospital for over one week compared to only 11% of drug misuse patients remaining in general acute hospitals for over one week (Tables B2.6 and B1.6).
Five year trends — 2000/01 to 2004/05
- Over the period 2000/01 and 2004/05 for Scotland (excluding NHS Fife and NHS Forth Valley) the total number of psychiatric discharges with a diagnosis of drug misuse (main or supplementary) rose initially, from 38 per 100,000 population in 2000/01 to 40 per 100,000 population in 2002/03. Figures then declined to 37 per 100,000 population in 2003/04. The 2004/05 rate of 38 per 100,000 was the same as in 2000/01 (Table B2.1).
- The rate per 100,000 population for drug misuse as the main diagnosis dropped from 25 per 100,000 population in 2000/01 to 22 per 100,000 population in 2004/05 (Table B2.1).
- The rate of discharges with drug misuse as a diagnosis (main or supplementary) per 100,000 population declined for age groups 24 years and under between 2000/01 and 2004/05 while for those aged 25 years and over the rate per 100,000 population increased over the time period (Table B2.1).
Drugs recorded
Opioids were the most common drug to be specifically recorded, seen in 25% of discharges (400), followed by cannabinoids, recorded in 9% of discharges (151) (Table B2.5).
Geographical profile
The highest rate of discharges per 100,000 population was seen in NHS Highland, with 78 per 100,000 population. Next was NHS Borders with 76 per 100,000 and Ayrshire and Arran with 67 per 100,000 (Table B2.1).
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.
These statistics are derived from data collected through the mental health inpatient and day case return (SMR04), which records information at admission and discharge. On the SMR04 form, up to six separate diagnoses can be recorded on discharge. A diagnosis in the first position is the main diagnosis on discharge. A diagnosis `in any position’, refers to the occurrence of a diagnosis in any of the six positions (including main and supplementary).
Figures for all admissions, re-admissions and discharges relate to the number of episodes not to the number of individual patients admitted or discharged. Each individual may have more than one episode. First admissions relate to first ever admissions to a psychiatric hospital, and therefore approximate to the number of people. It is also important to note that re-admissions will include patients who have returned for treatment after a long period of time, as well as those who have been re-admitted after a short interval.
Diagnosis is recorded on both the admission and the discharge part of the record and diagnosis on discharge may differ from diagnosis on admission. The tables presented here are based on diagnosis on discharge. Drugs misuse is defined using the same group of ICD 10 codes outlined in section B1. In tables B2.2 to B2.4 diagnoses have been grouped together into the following short list of conditions based on the International Classification of Diseases 10th Revision (ICD10):
ICD 10 Code |
Description |
F00-F03 |
Dementia |
F10 |
Alcohol Misuse |
F11-F16, F18-F19 |
Drug Misuse |
F20 |
Schizophrenia |
F30-F39 |
Mood (Affective) Disorders |
F31 |
-Bipolar Affective Disorders |
F32 |
-Depressive Episode |
F33 |
-Recurrent Depressive Disorder |
F04, F05, F09, F22, F23, F24, F28, F29 |
Other Psychotic Disorders |
F80-F84, F88-F89, F90, F93-F94, F98 |
Disorders of Childhood |
F40-F48 |
Neurotic, Stress-related and Somatoform Disorders |
F60 |
Personality Disorders |
F70-F79 |
Learning Disabilities |
All other codes from chapter 5 |
Other Conditions |
Data for NHS Fife for 2003/04 to 2004/05 and for NHS Forth Valley for 2004/05 is not available at the time of publication due to technical problems with data submission. The latest information on SMR04 data submission is included in SMR Situation Reports which are available from ISD Scotland’s website at http://www.isdscotland.org/isd/3274.html.
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 psychiatric admissions and discharges are available at: http://www.isdscotland.org/isd/info3.jsp?pContentID=962&p_applic=CCC&p_service=Content.show&
If you would like further information on psychiatric 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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