INTERPRETING HOSPITAL ADMISSIONS DATA ACROSS THE KORNER DIVIDE - THE EXAMPLE OF DIABETES IN THE NORTH-WESTERN REGION

Hospital admission rates and hospital bed utilization rates are presen ted for all admissions assigned to diabetes mellitus as principal caus e in the North Western Region from 1980/81 to 1990/91. Data are derive d from Hospital Activity Analysis (1980/81-1986/87) and from the Regio nal Information System (1988/89-1990/91). Admission rates for all cate gories of diabetes combined showed little change until 1986/87 after w hich they rose progressively each year. Hospital bed utilization rates fell progressively from 1986/87 onwards, the number of bed days attri buted to diabetes falling from 1.9 % to 0.8 % of the total for all cau ses. Most of the rise in admission rates from 1988/89 onwards was attr ibutable to diabetes with ophthalmic complications (ICD 250.4). This w as heavily influenced by the enumeration of day cases in the Regional Information System. When these are discounted, admission rates for the more recent years are stable. Diabetes without mention of complicatio ns (ICD 250.0) showed the most dramatic decline in its contribution to hospital bed utilization. This may be the result of increasing outpat ient support from diabetes specialist nurses whose numbers increased i n inverse proportion to the fall in bed utilization attributed to ICD 250.0.