Supporting your commitment to excellence
© Dr Rod Jones (2005)
Conditions most likely to cause
blockages within emergency hospital care
Dr Rod Jones (ACMA)
• Conditions scoring high across various dimensions of complexity include
Fractured neck of femur, Mental health conditions, Vascular and Respiratory
• Mental health conditions typically score high on average age, length of stay
and consequently bed usage.
• For acute care the diagnosis ‘Unknown and unspecified causes of morbidity’
features prominently – this may indicate the poor quality of diagnosis such as
‘patient unwell’ or ‘off legs’. Whatever the reason it points to the need for
excellent diagnostic processes at the front end of acute care.
• On the same basis the two most frequent diagnoses are unspecific, namely,
‘Pain in throat and chest’ and ‘Abdominal and pelvic pain’. Such non-specific
diagnoses once again point to the need for excellent diagnostic processes at the
front end of acute care.
• The complexity and uncertainty associated with current patterns of acute care
Many healthcare systems are seeking to identify those disease pathways where
particular focus should be placed in terms of ‘unblocking’ the delivery of emergency
The concept of a blockage to care is probably multi-factorial and hence this work
attempts to use various indicators of complexity
This analysis uses the primary diagnosis rather than HRG on the basis that primary
diagnosis is more focussed and gives a better indication of how the conditions are
reported. HRGs are derived from groups of diagnoses.
Source of the Data
Data covering the whole of England for the 2002/03 financial year was extracted from
the Department of Health Hospital Episode Statistics database using 3 digit
International Classification of Diseases (ICD) diagnosis codes.