Table 4.

Values for suggested NHS performance indicators for high blood pressure in England over five financial or calendar years

	Financial of calendar year					Trend for average annual improvement*
Outcome	Year 1	Year 2	Year 3	Year 4	Year 5 (95% CI)	%	R2	P value
Obesity†
No of adults obese	2 756	1 364	1 456	3 035	1 439
Obesity rate (%):
England	19.0	19.5	20.7	21.7	22.1 (21.0 to 23.1)	−4.1	0.972	0.002
GOR minimum	16.9	16.4	17.8	18.9	17.1 (14.2 to 20.0)
GOR maximum	22.3	22.9	24.2	25.2	26.2 (22.8 to 29.6)
High blood pressure‡
No of adults with HBP	4 339	NM	2 024	3 993	1 710
HBP rate (%):
England	35.4		34.5	35.3	33.3 (32.1 to 34.4)	1.2	0.509	0.287
GOR minimum	32.9		31.7	31.8	30.4 (26.9 to 34.0)
GOR maximum	39.5		39.2	40.9	36.6 (32.9 to 40.3)
Treated and controlled high blood pressure§
No of adults with controlled HBP	322	NM	194	417	226
Controlled HBP rate (%):
England	6.1		7.8	8.3	9.8 (8.2 to 11.3)	12.3	0.989	0.006
SHA minimum	4.3		3.6	6.5	5.3 (2.0 to 8.6)
SHA maximum	9.0		14.4	13.4	16.1 (7.8 to 24.3)
Hospitalisation for stroke (proxy for incidence)¶
No of admissions	69 478	67 785	65 027	64 884	66 038
Admission rate/100 000:
England	144.3	139.9	132.7	130.7	131.6 (130.6 to 132.6)	2.5	0.8	0.027
SHA minimum	113.9	95.3	97.2	93.2	101.4 (96.6 to 106.4)
SHA maximum	182.5	181.5	177.5	171.2	162.8 (156.3 to 169.6)
Stroke emergency readmissions**
No of readmissions	3 052	3 292	3 185	3 233	3 331
Readmission rate (%):
England	7.3	7.9	7.9	8.0	8.2 (7.9 to 8.4)	−2.3	0.759	0.054
SHA minimum	5.8	6.0	6.3	6.3	6.3 (5.1 to 7.7)
SHA maximum	11.7	11.3	11.5	10.9	9.8 (8.0 to 12.0)
Stroke hospital case fatality††
No of deaths	21 125	19 392	18 035	17 509	17 671
Death rate/1000:
England	304.2	286.6	274.2	267.9	266.8 (262.8 to 270.7)	3.2	0.9	0.014
SHA minimum	264.4	253.3	220.2	230.5	212.1 (186.4 to 240.3)
SHA maximum	341.5	343.2	317.1	315.3	302.9 (284.0 to 322.8)
Timely discharge to usual place of residence after stroke admission‡‡
No of discharges	29 911	29 953	29 346	29 296	29 840
Discharge rate (%):
England	47.9	48.9	49.9	50.1	50.7 (50.2 to 51.3)	1.4	0.949	0.005
SHA minimum	41.3	42.6	44.9	46.5	46.7 (44.3 to 49.1)
SHA maximum	53.1	52.9	55.4	56.1	58.4 (55.3 to 61.8)
Stroke population mortality§§
No of deaths	59 367	57 850	54 297	54 861	55 351
Death rate/100 000:
England	73.9	71.4	66.0	65.4	65.1 (64.6 to 65.7)	3.4	0.9	0.024
SHA minimum	60.5	60.6	54.5	54.9	51.2 (48.2 to 54.3)
SHA maximum	93.3	87.2	77.8	79.4	78.8 (75.9 to 81.7)

GOR=Government office regions. NM=Not measured. HBP=High blood pressure. SHA=Strategic health authorities (as at April 2003).

^*Fitting 2 linear trend to log transformed rates.

^†Adults (aged ≥16) with body mass index >30 for calendar years 1998-2002. Rates directly standardised for age and sex using the England 2001 census non-institutional adult population count. (Data source: health survey for England.)

^‡Adults (aged ≥16) who had a valid blood pressure reading and data on drugs with a mean systolic blood pressure of ≥140 mm Hg or diastolic pressure ≥90 mm Hg or currently taking prescribed drugs for blood pressure for calendar years 1998-2002. Rates directly standardised for age and sex using the England 2001 census non-institutional adult population count. (Data source: health survey for England.)

^§Adults taking prescribed blood pressure drugs with a blood pressure reading <140/90 mm Hg during health survey for calendar years 1998-2002. Rates (of all those with high blood pressure) directly standardised for age using the England 2001 census non-institutional adult population count. (Data source: health survey for England.)

^¶Emergency admissions of patients to hospital with stroke (primary diagnosis ICD-10 codes 161-164) for financial years 1998-9 to 2002-3. Rates indirectly standardised for age and sex per 100 000 residents of all ages, standardised to 2000-1. The denominators are mid-year population estimates for 1998-2002. (Data source: hospital episode statistics, Office for National Statistics.)

^**Emergency admissions of patients to any hospital between 0 and 27 days (inclusive) of live discharge after admission for stroke (primary diagnosis ICD-10 codes 161-164) for financial years 1998-9 to 2002-3. Rates indirectly standardised for age and sex per 100 000 residents of all ages, standardised to 2000-1. The denominators are mid-year population estimates for 1998-2002. (Data source: hospital episode statistics.)

^††Deaths occurring in hospital and after discharge among patients of all ages between 0 and 29 days (inclusive) of an emergency admission for stroke (primary diagnosis ICD-10 codes 161-164) for financial years 1998-9 to 2002-3. Rates indirectly standardised for age and sex per 1000 continuous impatient spells, standardised to 2000-1. (Data source: hospital episode statistics, Office for National Statistics.)

^‡‡Patients of all ages with an emergency admission for stroke (primary diagnosis ICD-10 codes 161-164) who had been discharged to their preadmission accommodation within 55 days (inclusive) of admission, for financial years 1998-9 to 2002-3. Rates indirectly standardised for age and sex as percentge of continuous inpatient spells, standardised to 2000-1. (Data source: hospital episode statistics.)

^§§Mortality from stroke (ICD-10 codes 160-169, ICD-9 codes 430-438) among residents of all ages for 1998-2002. These ICD codes are different from those used above because, unlike hospital episode statistics, data from Office for National Statistics do not have ICD-10 coding across all years, and there is no equivalent for ICD-10 161-164 in ICD-9. Years 1998 and 2000 use ICD-9, and years 1999, 2001, and 2002 use ICD-10. Data based on ICD-9 are adjusted for equivalence to ICD-10. Rates directly standardised for age per 100 000 residents, standardised to the European Standard Population. (Data source: Office for National Statistics.) See BMJ.com for further details on indicators.