To ask the Scottish Executive what the incidence of newly diagnosed respiratory problems has been in (a) Scotland, (b) NHS Forth Valley and (b) NHS Lanarkshire in each year since 2004, also broken down by data zone.
The information is not held centrally in the format requested.
The way that centrally held healthcare information is coded means that it is not always possible to reliably distinguish between respiratory problems that have been newly diagnosed (incident cases) and problems that the patient may have had for some time (prevalent cases). The figures presented in this response therefore count both newly diagnosed cases and pre-existing cases of respiratory problems.
A large number of diseases or conditions come under the heading of respiratory problems, ranging from short-term illnesses such as colds and influenza, through to long-term conditions such as asthma and chronic obstructive pulmonary disease (COPD). Both asthma and COPD are likely to be long-term problems and statistics on these conditions are regularly published by Information Services Division. Some of these statistics are reproduced below along with information on other respiratory problems.
Table 1 shows estimated numbers of patients consulting a GP or practice-employed nurse in Scotland for asthma, COPD or other respiratory problems, for the financial years 2004-05 to 2008-09. It is not possible from these data to reliably distinguish between newly and previously diagnosed cases. These figures are based on data from a small sample of general practices in Scotland that participate in the Practice Team Information (PTI) scheme. The patients registered to PTI practices are representative of Scotland as a whole in terms of their age, gender and deprivation profile. However, as they are not representative at NHS board level, PTI-based estimates are not produced by NHS board or for smaller areas. The figures in table 1 will be an underestimate of the true incidence of respiratory problems in Scotland as PTI only records instances where patients have actually consulted their GP practice for that particular problem during the year in question. More detailed information on consultations for asthma and COPD is published at www.isdscotland.org/pti.
Table 1: Patients in Scotland Consulting a GP or Practice-Employed Nurse for Asthma, COPD or other Respiratory Problems at least Once in the Year: Estimated Numbers1, with 95% Confidence Intervals2
Financial Year | | Asthma | COPD | Other Respiratory Problems3 |
2004-05 | Number | 281,421 | 98,805 | 1,062,397 |
Confidence Interval | (258,882-303,961) | (83,955-113,655) | (1,009,767-1,115,027) |
2005-06 | Number | 273,028 | 95,549 | 1,110,069 |
Confidence Interval | (253,541-292,514) | (80,724-110,374) | (1,054,379-1,165,759) |
2006-07 | Number | 267,751 | 93,556 | 1,119,636 |
Confidence Interval | (245,354-290,149) | (80,463-106,648) | (1,055,126-1,184,145) |
2007-08 | Number | 268,534 | 90,044 | 1,095,828 |
Confidence Interval | (243,302-293,767) | (79,675-100,412) | (1,030,317-1,161,338) |
2008-09 | Number | 284,029 | 95,549 | 1,119,742 |
Confidence Interval | (257,910-310,149) | (84,264-106,834) | (1,054,530-1,184,954) |
Notes:
1. Based on 53, 51, 49, 48 and 58 PTI practices that submitted complete GP and practice nurse data for the years ending 31 March 2005, 2006, 2007, 2008 and 2009 respectively.
2. As the estimates are based on data from a sample of practices, 95% confidence intervals are included to indicate the relative degree of certainty of these estimates.
3. Most other respiratory problems, excluding any consultations that have been coded by GPs or nurses as relating to circulatory and respiratory signs and symptoms and which therefore may or may not relate specifically to respiratory problems. This other group comprises a mixture of short and long-term problems (and many which can be short or long-term) and a wide range of conditions with varying degrees of severity. Conditions counted in this group include respiratory signs and symptoms, diseases, infections, and other respiratory tract problems. A full list of the conditions included in this group, along with their codes, is available on request from ISD''s PTI team at:
nss.isdPTIqueries@nhs.net.
Information on the numbers of patients who are registered to general practices and known to have asthma or COPD is also available through the Quality & Outcomes Framework (QOF) of the new General Medical Services contract. Table 2 shows the numbers of patients recorded by practices in Scotland, NHS Forth Valley and NHS Lanarkshire as having asthma or COPD, for the financial years 2004-05 to 2008-09. The information is slightly incomplete as it is not based on data from all general practices in Scotland (although the number missing is fairly small). These counts are based on QOF registers and comprise patients who may have been newly diagnosed in the year in question as well as those who had a pre-existing diagnosis of that condition. These counts are likely to include a mixture of patients who consulted their practice for asthma or COPD during the year and some patients who did not consult. The QOF does not require practices to report on other respiratory problems and so only figures for asthma and COPD are available. The QOF reports total asthma and COPD counts per general practice, so the figures cannot be broken down by data zone. More detailed information on the QOF is published at www.isdscotland.org/qof.
Table 2: Numbers of Patients Included on General Practice QOF1 Registers for Asthma or COPD, with Corresponding Crude Rates per 100 Registered Patients. Practices in Scotland, NHS Forth Valley and NHS Lanarkshire:
Financial Year | | Asthma | COPD |
Scotland | Forth Valley | Lanarkshire | Scotland | Forth Valley | Lanarkshire |
2004-05 | Number | 290,378 | 16,690 | 31,371 | 99,246 | 5,469 | 11,777 |
% | 5.4 | 5.6 | 5.4 | 1.9 | 1.8 | 2 |
2005-06 | Number | 290,908 | 16,721 | 31,758 | 97,743 | 5,206 | 11,668 |
% | 5.4 | 5.5 | 5.4 | 1.8 | 1.7 | 2 |
2006-07 | Number | 295,507 | 16,559 | 32,543 | 99,172 | 5,089 | 11,896 |
% | 5.5 | 5.4 | 5.5 | 1.8 | 1.7 | 2 |
2007-08 | Number | 299,005 | 16,532 | 33,033 | 101,596 | 5,205 | 12,152 |
% | 5.5 | 5.4 | 5.6 | 1.9 | 1.7 | 2.1 |
2008-09 | Number | 304,511 | 16,799 | 34,432 | 103,323 | 5,332 | 12,394 |
% | 5.7 | 5.6 | 5.8 | 1.9 | 1.8 | 2.1 |
Note: 1. The Quality & Outcomes Framework (QOF) is a part of the new General Medical Services contract, and comprises a framework of indicators that practices much achieve against in order to receive QOF funding.
Tables 3 to 5 below show the numbers of patients admitted to an acute hospital in Scotland for the first time as an inpatient or day case, for asthma, COPD or another respiratory problem, during the financial years 2004-05 to 2008-09. The counts exclude many patients with pre-existing diagnoses of respiratory problems. However, they may include patients who have previously been diagnosed with a respiratory problem elsewhere, for example in primary care, in an outpatients clinic, or outwith Scotland. The figures in tables 3 to 5 have been extracted from larger tables routinely published at http://www.isdscotland.org/isd/4334.html.
Table 3: First occurrence of respiratory disease as a main diagnosis within an acute hospital inpatient/daycase episode; Scottish residents; Financial years ending 31 March 2005-09:
Diagnosis Description | Financial Year |
2004-05 | 2005-06 | 2006-07 | 2007-08 | 2008-09 |
Total: Diseases of the respiratory system | 50,485 | 52,712 | 55,680 | 56,007 | 57,938 |
Acute upper respiratory infections and influenza | 8,450 | 9,773 | 9,365 | 10,433 | 9,464 |
Pneumonia | 9,472 | 10,156 | 11,194 | 10,952 | 11,766 |
Other acute lower respiratory infections | 9,517 | 10,410 | 11,836 | 11,466 | 11,998 |
Chronic diseases of tonsils and adenoids | 1,637 | 1,521 | 1,207 | 1,516 | 1,523 |
Other diseases of upper respiratory tract | 6,272 | 6,654 | 6,322 | 6,399 | 6,470 |
Chronic obstructive pulmonary disease and bronchiectasis | 5,796 | 5,303 | 5,984 | 5,728 | 6,547 |
Asthma | 3,813 | 3,300 | 3,883 | 3,300 | 3,695 |
Other diseases of the respiratory system | 5,528 | 5,595 | 5,889 | 6,213 | 6,475 |
Table 4: First occurrence of respiratory disease as a main diagnosis within an acute hospital inpatient/daycase episode; NHS Forth Valley residents; Financial years ending 31 March 2005-09:
Diagnosis Description | Financial Year |
2004-05 | 2005-06 | 2006-07 | 2007-08 | 2008-09 |
Total: Diseases of the respiratory system | 2,639 | 2,594 | 2,870 | 2,972 | 3,085 |
Acute upper respiratory infections and influenza | 432 | 470 | 500 | 558 | 411 |
Pneumonia | 539 | 477 | 460 | 446 | 515 |
Other acute lower respiratory infections | 429 | 554 | 612 | 671 | 751 |
Chronic diseases of tonsils and adenoids | 85 | 60 | 101 | 91 | 94 |
Other diseases of upper respiratory tract | 423 | 367 | 390 | 395 | 477 |
Chronic obstructive pulmonary disease and bronchiectasis | 283 | 285 | 352 | 302 | 319 |
Asthma | 232 | 160 | 216 | 192 | 178 |
Other diseases of the respiratory system | 216 | 221 | 239 | 317 | 340 |
Table 5: First occurrence of respiratory disease as a main diagnosis within an acute hospital inpatient/daycase episode; NHS Lanarkshire residents; Financial years ending 31 March 2005-09:
Diagnosis Description | Financial Year |
2004-05 | 2005-06 | 2006-07 | 2007-08 | 2008-09 |
Total: Diseases of the respiratory system | 6,236 | 6,418 | 6,888 | 6,327 | 6,689 |
Acute upper respiratory infections and influenza | 1,198 | 1,397 | 1,481 | 1,466 | 1,367 |
Pneumonia | 1,057 | 1,201 | 1,301 | 1,131 | 1,271 |
Other acute lower respiratory infections | 1,185 | 1,218 | 1,480 | 1,344 | 1,350 |
Chronic diseases of tonsils and adenoids | 280 | 146 | 58 | 53 | 106 |
Other diseases of upper respiratory tract | 793 | 930 | 779 | 691 | 809 |
Chronic obstructive pulmonary disease and bronchiectasis | 668 | 570 | 670 | 605 | 734 |
Asthma | 448 | 404 | 466 | 387 | 377 |
Other diseases of the respiratory system | 607 | 552 | 653 | 650 | 675 |
Source: Information Services Division, NHS National Services Scotland.