Mortality: liver 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.

Rationale

The indicator aims to prevent premature mortality with the aim of lowering numbers to improve health outcomes. Liver disease is a major cause of death in England and the NHS can contribute to reducing premature deaths from both amenable and non-amenable causes. NICE's quality standards on liver disease and hepatitis B, based on NICE guidelines, include statements on preventative interventions, and identifying and managing liver disease.

Source guidance

Specification

Numerator: Number of deaths for which liver 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: Liver disease uses codes ICD10 K70 to 77, B15 to 19, C22, I81, I85, T86.4. The Office of National Statistics (ONS) publishes the full ICD10 classification available for the NOMIS explorable dataset.

Exclusions: None identified.

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: 978-1-4731-6820-6