Long-term monitoring of health inequalities: March 2022 report

Annual update of the long-term monitoring of health inequalities headline indicators.

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Drug-related hospital admissions aged under 75 years

Trends in drug-related hospital admissions

In 2020/21, over 10,300 individuals under the age of 75 were admitted to hospital for drug-related issues.

The rate of drug-related hospital admissions, which is based on the number of patients admitted to general acute and psychiatric specialties for drug misuse in each financial year, has shown a general upward trend since 1996/97 and is currently the second highest it has been in the time series with 213.2 admissions per 100,000 population, compared to 64.0 admission per 100,000 in 1996/97.

In their annual drug-related hospital statistics in Scotland report8, Public Health Scotland note that there was a marked decrease in drug-related hospital stays at the time of the first national COVID-19 lockdown. The number of drug-related hospital stays in April 2020 was 29% lower than the average number of stays in April 2018 and 2019, likely due to the measures put in place in response to the COVID-19 pandemic. It is therefore likely that the impact of the pandemic will have contributed to the decrease in drug-related hospital admissions seen for this indicator between 2019/20 and 2020/21, which is inconsistent with the recent upward trend.

Table 13.1: Trends in drug-related hospital admissions (aged <75), 1996/97-2020/21
Year Total admissions1 Population Rate per 100,000 (EASR)
1996/97 3,366 4,754,906 64.0
1997/98 3,801 4,740,269 73.6
1998/99 4,395 4,729,975 86.1
1999/00 4,734 4,721,298 94.1
2000/01 4,851 4,708,667 97.6
2001/02 5,205 4,703,661 105.7
2002/03 5,412 4,701,958 110.7
2003/04 5,124 4,702,431 106.0
2004/05 5,292 4,714,233 109.8
2005/06 5,019 4,735,320 104.0
2006/07 5,262 4,752,425 108.8
2007/08 5,790 4,783,452 119.3
2008/09 6,120 4,811,453 125.9
2009/10 6,009 4,835,007 124.0
2010/11 6,435 4,858,058 132.6
2011/12 6,384 4,888,316 131.1
2012/13 6,033 4,895,114 124.5
2013/14 6,624 4,903,074 137.5
2014/15 6,981 4,914,362 144.7
2015/16 7,836 4,935,283 162.3
2016/17 8,607 4,962,391 178.4
2017/18 9,258 4,976,829 191.9
2018/19 10,017 4,983,364 207.6
2019/20 10,881 4,997,455 224.7
2020/21 10,323 4,996,183 213.2

1. Total admissions counts the number of individuals who have been admitted to hospital for drug misuse in each financial year. Individuals admitted to hospital multiple times in the same financial year will only be included once per year.

Inequalities in drug-related hospital admissions, 2020/21

In 2020/21 the admission rate in Scotland’s most deprived areas was more than 21 times greater than that of the least deprived (655.4 cases per 100,000 compared to 30.2 per 100,000).

Figure 13.1 Drug-related hospital admissions <75 y by Income-Employment Index, Scotland 2020/21 (European Age-Standardised Rates per 100,000)

Trends in relative inequalities

Relative inequality levels for patients with drug-related hospital admissions have fluctuated over time. Although they have decreased from a high of 3.06 in 1998/99 the RII for 2020/21 (2.82) is higher than at the start of the time series (2.77).

Figure 13.2 Relative Index of Inequality (RII): Drug-related hospital admissions <75y Scotland 1996/97 - 2020/21

Since 1996/97 admission rates (aged <75) have ranged from 15-28 times higher in the most deprived areas compared to the least deprived areas.

Trends in absolute inequalities

The absolute gap in drug-related hospital admission rates between those living in the most deprived areas and the least deprived areas has increased overall since the start of the time series. After an initial increase between 1996/97 and 1998/99 the absolute gap remained relatively stable, ranging from 309.8 – 384.7 per 100,000 between 1999/00 and 2013/14. The gap then increased each year to reach a high of 696.1 per 100,000 in 2019/20 before falling slightly to 625.1 per 100,000 in 2020/21.

These fluctuations have mainly been driven by changes in drug-related hospital admissions in the most deprived areas, with drug-related hospital admissions in the least deprived areas also increasing but at a much lower scale.

Between 2019/20 and 2020/21 the rate of hospital admissions for those living in the most deprived areas decreased by 10%, whilst the rate stayed the same for those living in the least deprived areas. This decrease in the most deprived areas goes against the upward trend that was observed in the previous seven years and it is therefore possible that the reduction is a result of hospital admissions policies associated with the COVID-19 pandemic.

Figure 13.3 Absolute Gap: Drug-related hospital admissions <75y Scotland 1996/97-2020/21 (European Age-Standardised Rates per 100,000)

Contact

Email: morag.shepherd@gov.scot

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