Mortality: respiratory
Indicator
Under 75 mortality from respiratory disease.
Indicator type
Network / system level indicator. The indicator would be appropriate to understand and report on the performance of networks or systems of providers.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
The indicator focuses on prevention of premature mortality with the aim of lowering numbers to improve health outcomes. Respiratory disease is one of the top causes of death in England in those under 75. The indicator covers a range of conditions, including major respiratory diseases such as COPD. NICE's quality standards on asthma, chronic obstructive pulmonary disease in over 16s, tobacco, air pollution and pneumonia in adults, based on guidelines by NICE and other organisations, include statements that aim to improve outcomes in this area.
Source guidance
This indicator is an overarching outcome, supported by a number of NICE guidelines on respiratory conditions, including:
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Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline NG209 (2021, updated 2023)
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Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). NICE guideline NG245 (2024)
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Pneumonia in adults: diagnosis and management. NICE guideline CG191 (2014, updated 2023)
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Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline NG115 (2018, updated 2019)
Specification
Numerator: Number of deaths under 75 for which respiratory disease is given as the underlying cause of death, based on the original cause recorded on the death certificate.
Denominator: Mid-year population estimates.
Calculation: Directly age-standardised rate.
Definitions: Respiratory disease uses codes ICD10 J00 to J99. The Office of National Statistics (ONS) publishes the full ICD10 classification available for the NOMIS explorable dataset.
Exclusions: None.
Data source: Primary Care Mortality Database (PCMD) / ONS Mortality data; ONS annual mid-year population estimates.
Expected population size: ONS (2024)'s Estimates of the population for the UK, England, Wales, Scotland, and Northern Ireland, mid-2023 edition, MYE1, show that for England (2023), 91% (52,380,101 divided by 57,690,323) of people in England were aged under 75: 9,080 per 10,000 patients served by a network. There is no minimum number of patients required for network level indicators. However, consideration should be given to whether the majority of results would require suppression because of small numbers.
ISBN: 978-1-4731-6819-0