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New analysis shows current picture of diseases which were widespread in the Victorian era

Hospital admissions for gout increasing, with variation across the country

*HSCIC must be quoted as the source of these figures

*This report contains regional figures

New figures published for the first time today paint a current picture of hospital admissions5 for some diseases that were widespread during the 19th and early 20th centuries.

Hospital admissions for gout are increasing and are highest in patients aged 60 and above, the figures from the Health and Social Care Information Centre (HSCIC) show.

The report is part of the latest monthly provisional Hospital Episode Statistics (HES) publication and also focusses on tuberculosis (TB), whooping cough, measles and malnutrition. It shows that between May 2013 and April 20146:

  • Gout admissions7 have increased by a fifth since 2009-10 in England, with almost 5,800 admissions in the 12 months to April 2014. The latest gout admissions figure is a four per cent rise on the previous 12 month period (5,560) and a 22 per cent rise since 2009-10 (4,760).
  • Seven in 10 gout admissions were for patients aged 60 and above (4,060 or 70 per cent), with males making up two thirds (2,680 or 66 per cent of this figure).
  • There were 86,870 hospital admissions where gout was a primary or secondary diagnosis8, an increase of 16 per cent from the same period in 2012-13 (74,960) and an increase of 78 per cent on the same period in 2009-10 (48,720).

Regionally, there was variation for gout and TB admissions by area of residence9. Greater Manchester had the highest rate of gout admissions (15.0 per 100,000 population) and Thames Valley had the lowest (7.9 per 100,000 population). London had the highest rate of TB admissions (15.3 per 100,000 population), with North Yorkshire and the Humber having the lowest (1.5 per 100,000 population).

Admissions also showed variation by deprivation10. There were 13.5 gout admissions and 16.5 TB admissions per 100,000 population in the 10 per cent most deprived areas, with 8.3 gout admissions and 1.4 TB admissions per 100,000 population in the 10 per cent least deprived areas.

Today's report also shows that overall admissions where malnutrition was a primary diagnosis decreased from 683 in 2012-13 to 612 in 2013-14. However, during the same period there was an increase in overall admissions where malnutrition was a primary or secondary diagnosis, from 5,590 to 6,690.

Over the last five years there was a 71 per cent increase in hospital admissions where malnutrition was a primary or secondary diagnosis, from 3,900 admissions in 2009-10 to 6,690 admissions in 2013-14.

The report also showed that the highest mean length of stay in hospital was for malnutrition, at 19.5 days, followed by TB at 13.6 days, gout at 5.2 days and measles at 2.9 days. The lowest mean length of stay was for whooping cough at 2.7 days.

Kingsley Manning, Chair of the HSCIC, said: "It is fascinating to look at current statistics for some of the diseases and conditions that were prevalent in the 1800s and early 1900s.

"We are fortunate that these diseases are not as widespread today, however our figures do show that hospital admissions for gout are increasing. Healthcare organisations may be interested in undertaking further study into the trends highlighted in our report."

You can view the full report at:


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 220 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. Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts in England and from approximately 200 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 admissions and are reliant upon the accurate and complete recording of cause of hospital admission. Submissions from the independent sector in particular have improved significantly in recent years.

3. Counts of figures under 1,000 are exact and figures over 1,000 have been rounded to the nearest 10. Percentages have been rounded to the nearest whole number.

4. Rates per 100,000 of the population have been rounded to one decimal place.

5. 'Admissions' refers to the total number of finished admission episodes including emergency admissions. Please note that these data should not be described as a count of people as the same person may have been admitted or treated on more than one occasion.

6. The report covers the period May 2013 to April 2014. Where figures are included from previous years, they also cover the period May to April (e.g. May 2009 to April 2010).

7. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.

8. The number of episodes in which the patient had a primary or secondary diagnosis is where a diagnosis was recorded in any of the 20 primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.

9. The area of residence is the Clinical Commissioning Group (CCG) or Area Team (AT) containing the patient's normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another CCG/AT for treatment.

In April 2013 changes to the structure of the NHS came into effect ( Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) were abolished and were replaced with organisations such as Clinical Commissioning Groups (CCGs) and NHS England Area Teams (ATs). In addition there are now four NHS England Regions above the Area Teams in the structural hierarchy.

10. The Index of Multiple Deprivation (IMD) is a measure of multiple deprivation which ranks the relative deprivation of each area of England in a number of domains (such as health and income) and then combines the individual scores to produce a composite score for each area. The patient's residential postcode is then mapped to one of these areas and summarised into 10 groups (deciles) for presentation. The analysis in this topic uses IMD 2010 data. See for further details.

The population denominator is the population in each IMD decile. This was calculated by linking ONS population data to IMD 2010 data via Lower Super Output Area (LSOA) and aggregating in to IMD deciles. Please note that population estimates for IMD deciles are linked to ONS population data from 2010 as this is the latest data available within HES that can be mapped to the corresponding LSOAs. All other population estimates within this report and corresponding rates per 100,000 people, are based on 2012 population data.

11. For media enquiries please contact or 0300 303 3888.

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