Mental health inpatient activity

A National Statistics publication for Scotland

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Published

24 November 2020

Type

Statistical report

Author

Public Health Scotland

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• Conditions and diseases
• Mental health

See all releases

This page describes the methodologies used to produce the figures contained in this release. It includes details on what data are presented, the data sources, how groups are defined (if applicable) and how calculations are carried out.

1. Mental health hospital activity

The following information on Mental Health Hospital Inpatient Activity is presented:

• The number of admissions, discharges, stays, patients and hospital residents by NHS board of treatment, hospital and treatment specialty,
• Numbers and rates of discharges, patients and hospital residents by NHS board of treatment, diagnosis grouping and treatment specialty,
• Rates of discharges and patients by council area of residence and treatment specialty,
• Numbers and rates of discharges and patients by NHS board of residence, sex, age band and treatment specialty,
• Numbers and rates of discharges, patients and hospital residents by NHS board of residence, SIMD quintile and treatment specialty,
• The Relative Index of Inequality for discharges, patients and hospital residents by treatment specialty,
• The number of patients treated outwith their NHS board of residence by NHS board of residence and treatment specialty,
• Percentage readmissions within 28 and 133 days by NHS board of treatment for psychiatric specialties only,
• The number of stays by NHS board of treatment, length of stay category and treatment specialty.

Statistical Disclosure Control has been applied to this analysis.

A Scottish Morbidity Record 01 (SMR01) should be submitted for every episode of inpatient care in a general/acute hospital in NHS Scotland. A Scottish Morbidity Record 04 (SMR04) should be submitted for every episode of inpatient care in a mental health specialty in a psychiatric hospital or unit, or in a facility treating people with learning disabilities, in NHS Scotland. In addition, if the NHS contracts out psychiatric or learning disability care to a private care home or hospital, an SMR04 record should be generated for each episode.

When the SMR04 scheme was originally developed, inpatient stays in mental health specialties were often quite lengthy – perhaps several years – and this is still sometimes the case. To enable up-to-date monitoring of activity, the SMR04 record was developed with two elements: one completed and submitted on admission; and one completed and submitted on discharge. This was to ensure that it was not necessary to wait until discharge for information on the admission to become available (but if the stay is short, the admission and discharge information can be submitted together).

1.1 Admissions and discharges

• Analysis relating to admissions uses financial year of admission and analysis relating to discharges uses financial year of discharge. An individual may have multiple admissions and discharges within a financial year and all of these would be counted in number of admissions and discharges.
• A discharge represents the end of an SMR episode. A discharge is not necessarily the end of a stay in hospital. A discharge can mean: deaths; transfers to other specialties, consultants, significant facilities and hospitals; as well as routine discharges to home. In a similar way an admission represents the start of an SMR episode.

1.2 Patients

In this analysis, a patient is defined as an individual discharged from hospital (including as a transfer out) at least once during the financial year. Patients are counted only once in each financial year, even if they have been discharged more than once. This is only if these discharges are from the same specialty. If they have been discharged from both psychiatric and non-psychiatric specialties in the same financial year, they will be counted in each. Therefore, the two specialty totals may not sum to the overall specialty total. To calculate the total, patients are counted only once per year regardless of how many times they have been discharged in a year or whether they have been discharged from both specialties.  For further context, please read the Data Dictionary for the relevant section on the Open Data website.

1.3 Stays

A stay is a continuous, unbroken period of time a patient spends as an inpatient in an NHS facility. A patient may change specialty, consultant, significant facility and/or hospital during a continuous inpatient stay. Because of this, information used to assign a stay to a specific hospital or NHS board has to be taken from a single episode within the stay. The rules to assign information to a stay from the episodes within are defined as follows:

• NHS board – Taken from last episode
• Hospital – Taken from last episode
• Date of discharge – Taken from last episode

1.4 Hospital residents

In this analysis, a hospital resident is defined as an individual who is an inpatient in a psychiatric facility at midnight on 31 March, before the beginning of the next financial year (1 April). Although the term 'hospital resident' is used for simplicity, some people will be looked after in care homes (under contract to the local NHS board). This measure is not calculated for SMR01 information as, typically, patients do not experience long term stays in acute hospitals and, therefore, would not be thought of as 'residents'.

2. Crude rates

In this analysis, crude rates were calculated using the National Records of Scotland (NRS) midyear population estimates. Crude rates are calculated as the annual number of events relative to the size of the population, usually expressed per 100,000 population. The crude rate takes no account of differences between populations with regard to age and gender composition.