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AGEING POPULATION - Burden or Benefit?

abcd. AGEING POPULATION - Burden or Benefit?. Demographic Stream 11:30-12:30 Tuesday 22 January 2002 Balmoral Hotel, Edinburgh. abcd. Keeping track of elderly patients in general practice - impact on morbidity data Sue Davies Office for National Statistics.

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AGEING POPULATION - Burden or Benefit?

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  1. abcd AGEING POPULATION- Burden or Benefit? Demographic Stream 11:30-12:30 Tuesday 22 January 2002 Balmoral Hotel, Edinburgh

  2. abcd Keeping track of elderly patients in general practice - impact on morbidity dataSue DaviesOffice for National Statistics What impact will implementation of ICD-10 have on mortality statistics by cause in the elderly? Clare Griffiths Office for National Statistics

  3. abcd Keeping track of elderly patients in general practice - impact on morbidity data Sue Davies Head of Morbidity & Health Care TeamOffice for National Statistics

  4. Background to issue Data sources used Illustrative analyses Discussion Your ideas Further work Contents

  5. Trends in population aged 85+ Background

  6. England & Wales population aged 85+ (thousands) in 1971, 2000, 2025

  7. Trends in population aged 85+ Background • Morbidity at older ages • Increasing importance of analyses at oldest ages • Standard age-group analyses • Some age-specific morbidity rates don’t exhibit expected patterns

  8. General Practice Research Database (GPRD) Several million patients Up to 12 years of longitudinal data Agreed guidelines for recording of clinical data - all significant morbidity events - every prescription issued - all consultant outpatient referrals Anonymised, patient-based clinical records submitted on a regular basis Data sources (1)

  9. “Key Health Statistics from General Practice 1998” A publication of data from GPRD by ONS 211 practices in E&W, total population 1.4 million patients, 2.6% of the population of E&W Similar age/sex-distribution to E&W population Morbidity prevalence; prescription rates; referral rates; disease management Data sources (2)

  10. Hospital Episode Statistics (HES) In-patient care provided by NHS hospitals in England Consultant episodes Finished consultant episodes are indirect measure of hospital admissions Data sources (3)

  11. Age-specific prevalence of treated disease, women, 1998

  12. Age-specific prevalence of treated disease, men, 1998

  13. Age-specific prescription rates by BNF chapter, women, 1998

  14. Age-specific prescription rates by BNF chapter, men, 1998

  15. Age-specific outpatient referral rates by specialty, women, 1998

  16. Age-specific outpatient referral rates by specialty, men, 1998

  17. HES admission rates, England, 1996-97 Men Persons Women

  18. Doctors lack of inclination to refer the oldest patients to surgery Actual lower treatment rates Least healthy patients admitted to hospital Some diagnoses/treatments arising from home visits not entered on practice computer Time lag between patients dying and being removed from practice list Discussion - possible explanations

  19. ? Continuous improvement in (completeness of) data recording Careful interpretation of data analyses More use of other data sources, e.g. HES, disease registers Discussion - your ideas/possible solutions

  20. Compare GPRD data on hospitalisations with HES data, by specialty Analyse data from disease registers Combine a few years’ data together to make analyses more robust Planned further work

  21. abcd Keeping track of elderly patients in general practice - impact on morbidity data Sue Davies Head of Morbidity & Health Care TeamOffice for National Statistics

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