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Nutrition

Volume 472: debated on Thursday 21 February 2008

To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1396W, on nutrition, how many patients were (a) admitted to and (b) discharged from hospital with a diagnosis of (i) malnutrition, (ii) nutritional anaemia and (iii) other nutritional deficiencies in 2006-07, per 1,000 patient admissions, broken down by NHS trust. (185563)

The information is not available in the exact format requested.

Tables showing the rates of finished in year admission episodes for malnutrition/nutrition anaemias and other nutritional deficiencies per 1,000 hospital admission episodes and the rate of in year discharge episodes for the specified diagnosis per 1,000 hospital discharge episodes, have been placed in the Library. This does not represent how many patients were admitted or discharged with these specified diagnosis as a person may have more than one admission/discharge episode within the year for a particular diagnosis. The figures are by per 1,000 hospital admission episodes rather than per 1,000 patient admissions.

Also, it is not possible to add the number of admission/discharge episodes in each of the three diagnosis categories (malnutrition, nutritional anaemia and other nutritional deficiencies) to obtain the total number of episodes with these diagnoses because it is possible that a patient could have more than one of the diagnoses recorded in their episode which means the same episode could appear in all three categories.

To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1396W, on nutrition, what assessment he has made of the reasons for the trend in the diagnoses of (a) malnutrition, (b) nutritional anaemias and (c) other nutritional deficiencies since 1997-98. (185572)

The trend of a greater number of discharge episodes than admission episodes does not imply that patients are becoming malnourished or developing nutritional anaemia/other nutritional deficiencies during their time in hospital. It is not possible to compare admissions and discharges in this way because there are a number of reasons why we would expect there to be more discharge episodes than admission episodes with these diagnoses.

For example, a patient showing signs/symptoms of malnutrition etc. would often undergo various tests to establish the cause of the symptoms; it may not be until later (e.g. the patient’s last episode in a particular hospital—their discharge episode) that the results come back and a formal diagnosis of malnutrition can be made. Hence, waiting for test results could result in more diagnoses being recorded in the discharge episode.

Also, a diagnosis in the discharge episode will be the last diagnosis that a particular patient was being treated for. This does not mean that patients who have a discharge episode with a diagnosis of malnutrition/nutritional anaemia/other nutritional deficiencies were actually discharged from hospital still malnourished or with nutritional anaemia or other nutritional deficiencies.

It is not possible to add the number of admission/discharge episodes in each of the three diagnosis categories (malnutrition, nutritional anaemia and other nutritional deficiencies) to obtain the total number of episodes because it is possible that a patient could have more than one of the diagnoses recorded. This means the same episode could appear in all three categories.

The increase trend in finished in year admission and discharge episodes over time, is in part due to factors such as the improvements in quality/coverage of Hospital Episode Statistics data and clinical coding since 1997. These improvements in information submitted by the national health service have been particularly marked in the earlier years and need to be borne in mind when analysing time series.