Alcoholrelated Hospital Admissions Public Service Agreement PSA 25

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Alcohol-related Hospital Admissions Public
Service AgreementPSA - 25
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Alcohol in England

• 90 of adults drink alcohol
• DH recommended guidelines
• Men should not regularly exceed 3-4 units/day
• Women should not regularly exceed 2-3
  units/day
• 26 - around 10 million adults in England drink
  more than the Government's recommended guidelines
• Almost 2.6 million adults drink at "high risk
• 1.6 million men drink 50 units/week
• 1 million women drink more 35 units/week.

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Deaths due to Alcohol

• 14,982 deaths were estimated to be attributable
  to alcohol consumption in 2005
• Representing 3.1 of all deaths in England
• Men were more at risk of harm from their alcohol
  consumption than women
• 4.4 of male deaths
• 2.0 of female deaths

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• The highest number of deaths are in older age
  groups
• Young people were disproportionably affected
• among 16-24 year old males, 26.6 of all deaths
  were estimated to be attributable to alcohol
• compared to 1.4 among those aged 75 and over
• In those aged less than 35 years, deaths were
  most likely to occur from the acute consequences
  of alcohol consumption
• intentional self-harm
• road traffic accidents
• Beyond the age of 35 the most common causes of
  death attributable to alcohol were
• liver cirrhosis
• malignant neoplasm of the oesophagus and breast
• hypertensive diseases

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Hospital Admissions

• 6 of all hospital admissions
• 459,836 individuals admitted in 2005/06
• 811,443 admissions in 2006/07
• Rising by around 80,000 admissions a year
• AAFs were calculated for 48 conditions
• 13 conditions were wholly attributable to alcohol
  consumption
• 35 conditions were partially attributable to
  alcohol consumption

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• Most common reasons for hospital admission in
  males and females were
• Hypertensive diseases
• Mental and behavioural disorders due to use of
  alcohol
• Cardiac arrhythmias

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Conditions wholly attributable to alcohol

• Alcohol-induced pseudo-Cushing's syndrome (E24.4)
• Mental and behavioural disorders due to use of
  alcohol (F10 combines ICD 9 codes for alcoholic
  psychosis, alcohol dependence and alcohol abuse)
• Degeneration of nervous system due to alcohol
  (G31.2)
• Alcoholic polyneuropathy (G62.1)
• Alcoholic myopathy (G72.1)
• Alcoholic cardiomyopathy (I42.6)
• Alcoholic gastritis (K29.2)
• Alcoholic liver disease (K70)
• Chronic pancreatitis (alcohol induced) (K86.0)
• Ethanol/methanol poisoning (T51.0, T51.1)
• Toxic effect of alcohol, unspecified (T51.9)
• Accidental poisoning by and exposure to alcohol
  (X45)

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Conditions partially attributable to alcohol
consumption

• 35 Conditions
• Malignant neoplasms
• Diseases of the nervous system
• Diseases of the circulatory system
• Diseases of the digestive system
• Acute consequences of alcohol consumption

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PSA 25

• Rate of hospital admissions per 100,000
  population
• NI 39 (Local Area Agreements - LAAs)
• VSC 26 (NHS Operating Framework Vital Signs)
• Rising at 8 10 per year
• Predicted to rise by 25 over next 3 years
• Target to hold the rise to no more than 11
  over 3 years

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High Impact Changes

• Prioritize alcohol within LAAs and NHS Operating
  Framework Vital Signs
• Improve treatment
• Review pathways and access NATMS
• Evidence based practice Models of Care
• Implement IBA
• Health AE, Clinics, GPs
• Criminal Justice
• Develop activities to control alcohol misuse
• Identify local champions build the case for
  investment
• Provide local implementation of national media
  campaigns