In 2008, there are more than 4.8 million inpatient admissions to hospital in Spain, 0.6% more than in 2007

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28 December 29 Hospital Morbidity Survey. Year 28 In 28, there are more than 4.8 million inpatient admissions to hospital in Spain,.6% more than in 27 Pregnancy and delivery and diseases of the circulatory cause the most admissions 4,814,39 inpatient hospital admissions were registered in 28, that is,.6% more than in 27. The number of admissions per 1. inhabitants stood at 1,559. This figure was.9% lower than the 1,66 from the year 27, due to the greater relative growth experienced by the population. Pregnancy, delivery and puerperium 1 maintained the rising trend of previous, and registered the greatest number of admissions (13.2% of the total). They were followed by hospitalisations due to diseases of the circulatory (12.8%), diseases of the digestive (11.9%), diseases of the respiratory /(1.7%) and tumours (8.8%). By most frequent diagnosis group, males had a higher rate of hospital admissions per 1, inhabitants than females in diseases of the circulatory, digestive and respiratory s, tumours, injuries and poisoning, diseases of the nervous and mental disorders. 3. Admissions per 1, inhabitants, by most frequent diagnosis groups and sex. Year 28 2749 2.5 2. 1.5 1. 5 1521 1186 1438 174 1358 911 982 97 874 811 689 754 694 566 326 334 279 232 Pregnancy and delivery Circulatory Digestive Respiratory Tumours Injuries and poisoning Osteomioarticular Genitourinary Nervous Mental disorders Males Females 1 Within this group we included the diagnoses that lead to childbirth in any of its modalities (normal delivery, caesarean, premature delivery, etc.) and others, such as hypertension or haemorrhages that complicated pregnancy, delivery or the puerperium (the period from the convalescence of childbirth to the complete normality of the genital organs) 1

Among females, the number one cause of hospitalisation corresponded to pregnancy, delivery and puerperium, with 24.5% of the total, as compared with the 21.6% registered in the year 2. The growing participation of this group in the total of hospital admissions was in accordance with the evolution of the number of births in Spain, which in 28 reached its highest level since 1981. The following causes of hospitalisation in females corresponded to the group of diseases of the circulatory (1.6%), diseases of the digestive (9.6%), diseases of the respiratory (8.1%) and tumours (7.8%). Among males, the diseases that caused the highest number of hospitalisations were those of the circulatory, with 15.4% of the total. Next were the diseases of the digestive (14.6%), diseases of the respiratory (13.8%), tumours (9.9%) and injuries and poisoning (9.8%). Females accounted for 53.8% of the total admissions. If we were to exclude admissions due to pregnancy, delivery and puerperium, the higher percentage of participation would correspond to males (53.2%), and the three large groups of diseases leading to the highest number of hospital admissions would coincide for both sexes (circulatory, digestive and respiratory s). Admissions by large groups of diseases and by sex (% of total admissions for each sex). Year 28 MALES % of total male admissions FEMALES % of total female admissions FEMALES (without considering pregnancy, delivery and puerperium) % of total female admissions Circulatory 15.4 Pregnancy, delivery and puerperium 24.5 Circulatory 14. Digestive 14.6 Circulatory 1.6 Digestive 12.7 Respiratory 13.8 Digestive 9.6 Respiratory 1.7 Tumours 9.9 Respiratory 8.1 Tumours 1.3 Injuries and poisoning 9.8 Tumours 7.8 Injuries and poisoning 9.6 Hospitalisations by age and by large groups of diseases The average age of persons admitted to hospital was 51.9 (53.8 for males and 5.2 for females). Persons aged 85 of age and er accounted for 7.3% of total hospital admissions in 28, four tenths more than in 27. The relative participation of this age group in the total hospitalisations has grown gradually in recent, from 5.2% in the year 2. Likewise, worth noting was the increase, over the past two decades, in the percentage of participation of the est age groups (65-74, 75-84, 85 and over) over the total hospital admissions. These three age groups represented 38.3% of the total hospitalisations in 28, as compared with 34.7% in the year 1998 and 22.6% in 1988. 2

Hospital stays by sex, age and large groups of diseases The average stay per hospital admission was 6.96 days, as compared with 7.2 days in 27. By groups of diseases, the longest stays (without considering mental illness) corresponded to tumours (9.29 days) and diseases originating in the perinatal period (8.85 days). By age, the longest average stay corresponded to the group of persons over 95 (1.95 days), followed by the group aged 9-94 (1.4 days) and the group aged 85-89 (1.16 days). Average stay by age and sex. Year 28 DAYS 14 12 1 8 6 4 2 1-4 5-14 15-24 25-34 35-44 45-54 AGE GROUPS 55-64 65-74 75-84 85-89 9-94 +95 Males Females Reasons for discharge and admissions via Accident and Emergency The number of hospital admissions of persons admitted via Accident and Emergency represented 59.7% of the total admissions in 28, as compared with 59.9% in 27 and 59.7% in 26. By reason, 92.8% of the discharges were produced as a result of cure or improvement, 3.8% from death, 1.9% due to transfer to other centres and 1.5% due to other causes. The main causes of death in Spanish hospitals were tumours (24.4% of the total), diseases of the circulatory (22.4%), of the respiratory (18.%) and of the digestive (8.9%). Hospitalisations by Autonomous Community The highest number of hospital admissions per 1, inhabitants was recorded in Comunidad Foral de Navarra, followed by Illes Balears and Principado de Asturias. The Autonomous Communities of Canarias, Andalucía, Castilla-La Mancha and the autonomous city of Melilla presented the lowest numbers of admissions per 1, inhabitants. 3

Admissions per 1, inhabitants, by Autonomous Community of Hospitalisation. Year 28 TOTAL 1,559 Andalucía 9,27 Aragón 11,625 Asturias (Principado de) 12,11 Balears (Illes) 12,68 Canarias 9, Cantabria 1,193 Castilla y León 11,333 Castilla - La Mancha 9,342 Cataluña 11,688 Comunitat Valenciana 1,254 Extremadura 1,362 Galicia 1,965 Madrid (Comunidad de) 1,64 Murcia (Región de) 1,163 Navarra (Comunidad Foral de) 12,781 País Vasco 11,673 Rioja (La) 1,317 Ceuta 9,722 Melilla 9,184 By groups of diseases, pregnancy, birth and puerperium caused the highest rate of hospital admissions in Andalucía, Canarias, Castilla-La Mancha, Comunitat Valenciana, Extremadura, Comunidad de Madrid, Región de Murcia and in the autonomous cities of Ceuta and Melilla. In Illes Balears and Comunidad Foral de Navarra, the group of diseases of the digestive was the number one cause of admissions. On the other hand, diseases of the circulatory produced the most hospital admissions in the eight remaining Autonomous Communities. The Autonomous Communities with the longest average stays were Castilla y León (8.3 days), Cantabria (7.82 days), Galicia (7.82 days) and Principado de Asturias (7.8 days), whereas those with the shortest average stays were Illes Balears (5.72 days), Comunitat Valenciana (5.85 days) and the autonomous cities of Melilla (5.85 days) and Ceuta (5.96 days). 4

International Data: Shortlist for diagnosis groups for international dissemination (Eurostat/OECD/WHO) of Hospital Morbidity data With the hospital admissions information corresponding to the year 25, for the first time, the Shortlist for diagnosis groups for international dissemination of Hospital Morbidity data was published, agreed upon by the main international institutions in this area (Eurostat, OECD and WHO), and which will allow for a homogeneous comparison of the figures and diagnoses among countries in coming. Hospital admissions per 1, inhabitants for different countries and diagnosis groups 2. Year 27 Countries All diagnoses circulatory respiratory digestive Pregnancy and childbirth ** Germany 22,693 3,392 1,396 2,12 2,147 Canada * 8,429 1,14 73 914 2,521 Spain 1,66 1,323 1,168 1,256 2,751 United States * 12,632 1,996 1,17 1,177 3,87 France 27,377 2,278 1,256 3,219 4,75 Italy * 13,887 2,216 1,51 1,357 2,442 Portugal 1,83 1,36 965 1,81 1,933 United Kingdom 12,554 1,296 1,157 1,164 2,732 Turkey 1,486 1,183 1,23 93 2,959 * Data corresponding to the year 26 ** Pregnancy and childbirth per 1, women Average stay in days, for different countries and diagnosis groups 2. Year 27 Countries All diagnoses circulatory respiratory digestive Pregnancy and childbirth Germany 1. 1.4 9. 7.4 4.8 Canada * 7.3 8.4 7.4 5.9 2.6 Spain 7.2 8.3 7.2 5.9 3.2 United States * 4.8 4.5 5.1 4.6 2.7 France 5.7 6.9 7. 5.3 4.8 Italy * 6.8 7.7 7.9 6.8 4.1 Portugal 5.8 7.4 8. 5.6 3.4 United Kingdom 8. 1.5 7.5 6.2 2.4 Turkey 5. 4.6 5.2 5.3 2.2 * Data corresponding to the year 26 2 Source: OECD (Further information available on the website: http://www.oecd.org/els/health/data). The complete list of diagnoses included in the Eurostat/OECD/WHO Shortlist is published in tables 3.1-3.4 and 4.1-4.4 of the Hospital Morbidity Survey 25-28. 5

Methodological note The main objective of the Hospital Morbidity Survey is to ascertain the demographic-health features of the patients discharged who have been admitted to a hospital and have stayed there at least one night, as well as to provide information on a state and provincial level on the rate of visits and use of hospital resources during a reference year. The Survey collects information by a sampling of 87% of both public and private Spanish hospitals in 28, such that the number of patients collected directly from hospitals reaches 95% of total inpatient hospital admissions taking place annually in Spain. Health information focuses on the main diagnosis stated in the hospital discharge report received by the patient, and which caused his or her admission according to the criteria of the clinical department or doctor who treated the patient. The features collected from the patient are as follows: sex, age, date admitted, date discharged, province of residence, type of admission and reason for discharge. The Survey allows for determining the average stay for each type of diagnosis, ascertaining the scope of influence of hospitals according to the province of residence of the patient, and performing epidemiological studies of certain diseases. As of the year 25, we have microdata with a breakdown level of four digits in the main diagnosis, in accordance with the International Classification of Diseases. (ICD-9-MC). As of that same year, the publication includes the International Shortlist of Diagnosis Groups agreed upon by Eurostat, OECD and the WHO for the dissemination of Hospital Morbidity data. For further information see INEbase-www.ine.es All press releases at: www.ine.es/prensa/prensa_en.htm Press office: Telephone numbers: 91 583 93 63 / 94 8 Fax: 91 583 9 87 - gprensa@ine.es Information area: Telephone number: 91 583 91 Fax: 91 583 91 58 www.ine.es/infoine 6