title: Recent trends in liver resection surgery activity and population utilization rates in English regions.
abstract: OBJECTIVE
  We conducted a study to examine recent trends in population-based utilization rates for liver resection surgery in England, to help identify potentially unmet healthcare need and to help inform future service planning.
  
  
  METHODS
  Hospital Episodes Statistics data were analysed for the 5-year period 2000-1 to 2004-5 to identify episodes of care relating to liver resection surgery (defined as OPSC IV codes J21 to J24, J31, J38 and J39).
  
  
  RESULTS
  In England, the liver excision surgery population access rate was 1.82 and 2.95/100,000 general population in 2000-1 and 2004-5, respectively--a 62% increase during the 5-year study period, or a mean 12% annual increase. About two-thirds of all liver resection surgery (69%) related to metastatic liver disease. Between English regions, utilization rates ranged from 0.5 to 4.5/100,000 general population in 2000-1; and from 0.8 to 4.6/100 000 general population in 2004-5.
  
  
  CONCLUSIONS
  In recent years, a rapid increase in liver resection surgery activity has been observed. Most of the activity was related to metastatic disease. There was substantial regional variation in population utilization rates within the same country. This variation is unlikely to represent regional differences in disease burden and healthcare need.
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. gl290@medschl.cam.ac.uk
authors.forename: Georgios
authors.initials: G
authors.lastname: Lyratzopoulos
authors.forename: Claire
authors.initials: C
authors.lastname: Tyrrell
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
authors.forename: Julia
authors.initials: J
authors.lastname: Yelloly