Hospitalisation profile in England and Wales, 1999 to 2019: an ecological study

Abstract

ObjectiveHospital-related indicators are used to prioritise, benchmark and monitor certain healthcare components to improve quality. This study aimed to determine the hospital admissions profile in England and Wales between 1999 and 2019.DesignEcological study.SettingA population-based study of hospitalised patients in England and Wales.ParticipantsAll patients of all ages and genders who were hospitalised in National Health Service (NHS) hospitals and NHS-funded independent sector hospitals.Outcome measureHospital admission rates in England and Wales related to various diseases/causes, which were identified using the diagnostic codes (A00-Z99).ResultsThere was a 48.5% rise in hospital admission rates from 246 366.7 (95% CI 246 249.8 to 246 483.7) in 1999 to 365 858.7 (95% CI 365 736.3 to 365 981.2) in 2019 per million persons (p<0.05). The most common causes of hospital admissions were diseases of the digestive system; symptoms, signs, and abnormal clinical and laboratory findings; and neoplasms, which accounted for 11.5%, 11.4% and 10.5%, respectively. The age range of 15–59 years accounted for 43.4% of all hospital admissions. Around 56.0% of all hospital admissions were by female patients. In comparison to 1999, the hospital admission rate for males grew by 53.7%, from 218 363.7 (95% CI 218 203.2 to 218 524.3) to 335 618.9 (95% CI 335 448.1 to 335 789.6) per million persons in 2019. When compared with 1999, the hospital admission rate for females increased by 44.7%, rising from 273 032.5 (95% CI 272 863.5 to 273 201.5) to 395 154.6 (95% CI 394 979.9 to 395 329.4) per million persons.ConclusionA notable increase was observed in the rate of hospital admissions for all causes in England and Wales. Elderly age and female gender were significant factors that influenced the rate of hospital admissions. Future research is required to identify preventable risk factors for hospital admission.