HES Admitted Patient Care (HESAPC) Dataset

# define target dataset to document
schema = 'nhsd'
table = 'HESAPC'
version = 'v0003'
# import functions from script helper
import sys
script_fp = "../../../../scripts/"
sys.path.insert(0, script_fp)
from data_doc_helper import DocHelper
# create instance
document = DocHelper(schema, table, version, script_fp)
# markdown/code hybrid cell module requirement
from IPython.display import display, Markdown

1. Summary

display(document.style_table(document.get_dataset_info()))

Dataset descriptor	Dataset-specific information
Name of dataset in TRE	HESAPC
Other name	None
Keywords	Inpatients, NHS hospitals
Short description	Dataset of patients admitted for treatment at NHS hospitals in England, either as day cases or overnight and either as emergency or planned admissions. A record represents one episode. The dataset includes delivery and birth data, but note maternity data are also collected in the Maternity Services Data Set (MSDS). Some measures are available in both datasets (e.g. ethnicity of the mother) and some are unique to one dataset (e.g. MSDS collects the mother’s smoking status and HESAPC collects the length of hospital stay). In reports, HESAPC data are used for the national totals, because they have historically been more complete.
Owner	NHS England
Geographical coverage	England
Temporal coverage	01/04/1989 onwards
TRE temporal coverage	01/04/1998 onwards
Frequency of update	Quarterly
Date of last extract	None
DOI	None
Data resolution	Inpatient episode
Number of variables	None
Number of participants	None
Number of observations	None
Version	None
Key link	https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/hospital-episode-statistics
Specific restrictions to data use	None

2. Structure of the HESAPC dataset

Episodes and spells

Data in the HESAPC dataset are organised into episodes and spells. Each row indicates a Finished Consultant Episode (FCE), which is a continuous period of care under one consultant at a single hospital. A spell is a continuous period of care within a single hospital from admission to discharge or death. Most patients in the HESAPC datasets are represented by one row of data (i.e. a spell comprising one episode), but others may be represented by multiple rows if they move between consultants within or between hospitals (see the scenario below). Furthermore, in the HESAPC_MAT dataset, each birth generates at least two episodes, one recording details of the delivery (relating to the mother) and one episode per child delivered (relating to the child).

If the patient was seen by multiple consultants during the same stay at the same hospital, a spell may contain one or more FCEs, i.e. one or more rows of data per patient (see figure 1). The first (or only) FCE can also be called a Finished Admission Episode (FAE) and the final (or only) FCE can also be called a Discharge Episode. This is why there are more FCEs than FAEs in the APC dataset: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity.

Figure 1 Episodes and spells in the HESAPC dataset - each row of data in the dataset corresponds to a single FCE

Continuous Inpatient (CIP) spells

A more complex scenario again is if a patient is transferred to a different hospital. In this instance, a new spell begins. To identify and measure continuous hospital stays, which include transfers to other hospitals, Continuous Inpatient (CIP) spells need to be derived (see figure 2).

Figure 2 Spells and CIP spells in the HESAPC dataset

Episodes/spells that span financial years

FCEs are entered into the HESAPC dataset according to the financial year in which they end. Consequently, episodes/spells that start in one financial year and end in another will be classified as unfinished in the starting financial year and finished in the ending financial year. Unfinished episodes/spells need to be removed before analysis to prevent double counting.

3. Metrics

The tables below summarise the HESAPC dataset in the UK LLC TRE.

Table 1 The number of participants from each LPS that are represented in the HESAPC dataset in the UK LLC TRE
(Note: numbers relate to the most recent extract of NHS England data)

display(document.style_table(document.get_cohort_count()))

LPS	Participant count
ALSPAC	4644
BCS70	5082
BIB	27111
ELSA	6528
EPICN	14161
EXCEED	8411
FENLAND	8690
GLAD	57687
MCS	16009
NCDS58	5536
NEXTSTEP	4111
NIHRBIO_COPING	14278
NSHD46	2820
TEDS	5553
TRACKC19	11317
TWINSUK	11762
UKHLS	5924
TOTAL	209624

4. Helpful syntax

Below we will include syntax that may be helpful to other researchers in the UK LLC TRE. For longer scripts, we will include a snippet of the code plus a link to Git where you can find the full script.