Appendix G: SPARRA Data | Right Decisions

What is SPARRA?⁷

Scottish Patients at Risk of Readmission and Admission is a risk prediction tool developed by ISD which predicts an individual's risk of being admitted to hospital as an emergency inpatient within the next year.

What is a SPARRA Score?

Scores are calculated for approximately 4.2 million patients. Information on those whose score indicates that they may be at increased risk of emergency admission are accessed by authorised health care professionals in NHS Boards, CHPs and GP practices. SPARRA scores can range from 1 to 99% for patients in the cohort. Patients with a score of 50%, for example, are generally said to have a 1 in 2 chance of being admitted to hospital in the prediction year.

What is the purpose of SPARRA?

There is growing recognition of the need to shift from a healthcare system geared towards reactive, hospital-based treatment of acute conditions to one that is more community based with a preventative and anticipatory approach.

SPARRA data can help health-care professionals to prioritise patients with complex care needs who are likely to benefit most from anticipatory health care. SPARRA data can also be used in a service planning capacity by locating groups of patients who would benefit from specific interventions or services.

⁷ http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/SPARRA/

Table 1a. SPARRAA patients aged 50 years and older, residing in a care home on 1st May 2017

These patients have any risk score (1%-99%).

The numbers in these groups by NHS Board are shown in Tables 1a and 1b. It should be noted that the two groups overlap, so many patients will be in both groups A and B. (Of the patients included in Table 1a as resident in a care home, 6854 aged 75 and over also appear in Table 1b and 7354 aged 65 and over also appear in Table 1b.)

	Age 50+
NHS Board	Number of People in a Care Home^D
NHS Ayrshire & Arran	2,577
NHS Borders	551
NHS Dumfries & Galloway	979
NHS Fife	2,387
NHS Forth Valley	1,600
NHS Grampian	3,010
NHS Greater Glasgow & Clyde	6,779
NHS Highland	1,962
NHS Lanarkshire	3,283
NHS Lothian	4,153
NHS Orkney	84
NHS Shetland	71
NHS Tayside	2,869
NHS Western Isles	178
Total	30,483

Table 1b. Patients aged 75+ and 65+ in SPARRAA on 1st May 2017 with a risk score of 40-60% who were dispensed items from 10 or more BNF sections

	Age 75+					Age 65+
NHS board	Number of patients dispensed drug items from 10 or more BNF sections	Number of patients with high risk medicines^C	Number of patients in a care home^D	Number of patients with high risk medicines and in a care home	Number of patients with dementia^E	Number of patients dispensed drug items from 10 or more BNF sections	Number of patients dispensed high risk medicines^C	Number of patients in a care home^D	Number of patients with high risk medicines and in a care home	Number of patients with dementia^E
NHS Ayrshire & Arran	3,894	3,808	647	629	556	4,999	4,883	689	670	599
NHS Borders	990	961	134	126	182	1,208	1,169	142	134	190
NHS Dumfries & Galloway	1,546	1,496	245	235	280	1,908	1,849	269	259	304
NHS Fife	2,928	2,828	579	549	641	3,642	3,525	617	587	686
NHS Forth Valley	2,155	2,092	320	312	371	2,738	2,660	344	334	408
NHS Grampian	3,249	3,144	531	514	537	4,052	3,914	572	553	576
NHS Greater Glasgow & Clyde	10,331	10,054	1,632	1,568	1,745	13,338	12,970	1,769	1,699	1,890
NHS Highland	2,480	2,400	403	385	455	3,092	2,990	432	413	491
NHS Lanarkshire	5,630	5,478	716	699	984	7,271	7,077	774	756	1,073
NHS Lothian	5,651	5,469	955	912	1,134	7,061	6,834	1,020	974	1,223
NHS Orkney	147	141	19	16	17	179	171	19	16	18
NHS Shetland	160	156	13	13	25	189	184	13	13	25
NHS Tayside	3,452	3,339	623	592	620	4,170	4,040	652	620	658
NHS Western Isles	269	264	37	37	44	343	334	42	42	49
Total	42,882	41,630	6,854	6,587	7,591	54,190	52,600	7,354	7,070	8,190

^A SPARRA (Scottish Patientts At Risk of Re-admission or Admission) is a risk prediction model that estimates the risk of emergency admission to hospital in the next 12 months (1 May 2017 - 30 April 2018).

^B The number of different BNF sections from which a patient's drugs were prescribed and dispensed. SPARRA Version 3 uses the most recent 12 months prescribing data available prior to the start of the risk year.

^C Defined as medications in any of the following BNF Sections: 2.1, 2.2, 2.4, 2.5, 2.8, 2.9, 4.1, 4.2, 4.3 and 10.1.

^D Identified by a CHI institution code of 93 or 98.

^E Evidence of dementia has been determined either by prescribing history (dispensed items within BNF Section 4.11) or previous inpatient admission to hospital where diagnosis at discharge includes ICD10 codes (F00-F03, F051); and ICD9 codes (2900, 2901, 2902, 2904, 2908, 2909).