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Hospital statistics on teenagers: girls predominate in self-harm cases, boys in assaults

October 1, 2013: New analysis also shows common causes and conditions among younger children

*HSCIC must be quoted as the source of these figures

New analysis from the Health and Social Care Information Centre (HSCIC) shows marked differences in what children are treated for in hospital according to their age and gender.

While there is common ground in many of the most frequently recorded diagnoses and external causes, today's report shows a much higher number of self-harm hospital cases5 among teenage girls than boys, and in contrast a higher number of cases among boys than girls resulting from assault.

In the 12 months to June 2013; there were 13,400 hospital cases where 15-19 year-old girls received treatment for an external cause of intentional self-harm6 (accounting for five per cent of the total cases for this group). This compares to 4,000 cases among 15 to 19 year-old boys (or three per cent of the total cases for this group).

In contrast, hospitals recorded 2,400 cases where 15 to19 year-old boys required treatment due to an external cause of assault by bodily force, compared to 4207 cases among girls of the same age.

It should be noted that an external cause, which can be anything from a fall to a road traffic collision, is only recorded in a small number of hospital cases.8

Today's special topic is presented as part of HSCIC's monthly provisional Hospital Episode Statistics publication, which shows data broken down by age, diagnosis and cause, along with summary information on outpatient appointments and A&E attendances for children. It shows that in the 12 months to June 2013:

  • There were 2.5 million hospital cases for children aged 0 to19. This was a very small increase of 0.1 per cent on the previous 12 months.
  • Boys had more hospital cases than girls in all age groups, except among 15 to19-year-olds.

Infants

  • More hospital cases were recorded for children under one (just over one million) than in any other child age group, although most of these were related to the birth or conditions arising immediately after birth.

One to four year-olds

  • Where an external cause was recorded, the most common for girls (1,600) and second most common for boys (1,700) was a "foreign body entering into or through an eye or natural orifice".
  • A "viral infection of unspecified site" was the most common primary diagnosis, with 31,900 for boys and 19,200 for girls.
  • Boys accounted for nearly twice as many cases with a primary diagnosis of asthma (6,800) compared to girls (3,500).

Five to nine year-olds

  • Where an external cause was recorded, the most common for both boys (2,100) and girls (1,700) was "fall involving playground equipment"
  • Dental caries (tooth decay9) was the most common primary diagnosis, with 13,300 cases for boys and 12,000 for girls.
  • Boys accounted for substantially more cases with a primary diagnosis of fractured forearms (4,100), compared to girls (2,800).

HSCIC Chair Kingsley Manning said: "Today's report is one of the first to examine hospital activity for children in this country to such a significant degree of detail.

"It highlights the differing reasons why children are coming through hospital doors in this country and in particular the marked variation between boys and girls in the conditions they are being treated for. The number of self-harm cases among girls and assault cases among boys makes for particularly compelling reading."

The full report is at: www.hscic.gov.uk/pubs/hesapr13jun13

Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 130 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. Today's press release focuses on a special topic which is part of a wider monthly publication of all NHS-commissioned provisional inpatient, outpatient and A&E activity in England. The publication includes provisional monthly data for April 2012 to June 2013 and final data from July 2011 to March 2012.

3. Percentages over 1.0 have been rounded to one percentage point. Numbers over 100 have been rounded to the nearest 10 and over 1,000 have been rounded to the nearest 100.

4. Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England and from some independent sector organisations for activity commissioned by the English NHS. The HSCIC liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies. While this brings about improvement over time, some shortcomings remain. Figures refer to recorded cases and are reliant upon the accurate and complete recording of cause of hospital admission.
HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality, coverage of data recorded (particularly in earlier years), improvements in coverage of independent sector activity and changes in NHS practice.

5. Where this release refers to 'case', the full report uses the standard hospital term 'finished consultant episode (FCE). An FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the period in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.

6. The ICD10 codes used within the report to identify the external cause of self harm are:

X60 Intentional self-poisoning/expos to nonopiod analges antipy & antirheumatics
X61 Intentional self-poisoning/expo ant-epi sed-hyp ant park & psy'trop drugs
X62 Intentional self-poisoning/expos narcotics & psy'dysleptics [hallucinogens)
X63 Intentional self-poisoning/expos other drug act on autonom nervous system
X64 Intentional self-poisoning/expos to other & unspecified drugs medics & biological substances
X65 Intentional self-poisoning by and exposure to alcohol
X66 Intentional self-poison/expos org solvents +halogen hydrocarbons
X67 Intentional self-poisoning by and exposure to other gases and vapours
X68 Intentional self-poisoning by and exposure to pesticides
X69 Intent self-poisoning/exposure other and unspecified chemicals and noxious substances
X70 Intent self-harm by hanging strangulation and suffocation
X71 Intentional self-harm by drowning and submersion
X72 Intentional self-harm by handgun discharge
X73 Intent self-harm by rifle shotgun & larger firearm discharge
X74 Intent self-harm by other and unspecified firearm discharge
X75 Intentional self-harm by explosive material
X76 Intentional self-harm by smoke fire and flames
X77 Intentional self-harm by steam hot vapours and hot objects
X78 Intentional self-harm by sharp object
X79 Intentional self-harm by blunt object
X80 Intentional self-harm by jumping from a high place
X81 Intentional self-harm by jumping or lying before moving object
X82 Intentional self-harm by crashing of motor vehicle
X83 Intentional self-harm by other specified means
X84 Intentional self-harm by unspecified means
Y87.0 Seq intentional self-harm assault & events undetermined intent

7. The ICD10 codes used to identify the external cause of assault within the report are X85-Y09

X85 Assault by drugs, medicaments and biological substances
X86 Assault by corrosive substance
X87 Assault by pesticides
X88 Assault by gases and vapours
X89 Assault by other specified chemicals and noxious substances
X90 Assault by unspecified chemical or noxious substance
X91 Assault by hanging, strangulation and suffocation
X92 Assault by drowning and submersion
X93 Assault by handgun discharge
X94 Assault by rifle, shotgun and larger firearm discharge
X95 Assault by other and unspecified firearm discharge
X96 Assault by explosive material
X97 Assault by smoke, fire and flames
X98 Assault by steam, hot vapours and hot objects
X99 Assault by sharp object
Y00 Assault by blunt object
Y01 Assault by pushing from high place
Y02 Assault by pushing or placing victim before moving object
Y03 Assault by crashing of motor vehicle
Y04 Assault by bodily force
Y05 Sexual assault by bodily force
Y06 Neglect and abandonment
Y07 Other maltreatment
Y08 Assault by other specified means
Y09 Assault by unspecified means

8. Every HES record has a primary diagnosis, this is the reason that the patient is being treated in hospital, for example a broken leg. Causes may be recorded where an external event has led to a patient's admission to hospital, for example a road traffic accident. An external cause is not recorded for the majority of cases as there need not be an external cause of the primary diagnosis. For the 12 month period covered by this report, the external cause was recorded for 7 per cent of Finished Consultant Episodes for children aged 0-19. The report and release also provides information on the primary diagnoses for patients. The primary diagnosis is the first of up to 20 diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.

9. The term 'dental caries' (a.k.a. tooth decay) refers to both a disease of the teeth that is caused by an interaction of food and bacteria leading to erosion of the outer layers of the teeth causing cavities, and the cavities themselves.

10. For media enquires please call 0845 257 6990 or email media@hscic.gov.uk

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