Cause-specific hospital utilisation and mortality patterns in New Zealand by area deprivation, Ngaire Coombs Zoë Matthews, Sabu Padmadas Division of Social Statistics, School of Social Sciences, University of Southampton

New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

Aims Data Results Discussion Further Work? Outline

Aims 1.To determine if areas with high deprivation scores have higher mortality rates than areas with low deprivation scores. 2.To determine if areas with high deprivation scores have higher hospital bed day rates than areas with low deprivation scores. 3.To determine if the cause of death varies by deprivation score. 4.To determine if the cause of hospital use varies by deprivation score.

Mortality * (800,000 events) Hospital Discharges (20 million events) NZDep Area deprivation score 1991, 1996, 2001, 2006 National analyses Sub-national analyses (by deprivation) Data *Excluding 2001

Hospital Discharges, Hospital Bed Days,

Hospital Discharges, Hospital Bed Days,

Filtering of Hospital Data

Hospital Discharges, Hospital Bed Days,

Hospital Discharges, Hospital Bed Days,

Results

Standardised* Hospital Bed Day and Mortality Rates Hospital Bed Day rateMortality rate (per 1000) *Standardised to 1991 New Zealand Population

1.To determine if areas with high deprivation scores have higher mortality rates than areas with low deprivation scores. 2.To determine if areas with high deprivation scores have higher hospital bed day rates than areas with low deprivation scores. Aims

Hospital Bed Day and Mortality rates by Deprivation, Age 60-64, 2002 Mortality rate (per 1000)Hospital Bed Day rate

Hospital Bed Day and Mortality rates by Deprivation, Age 80-84, 2002 Mortality rate (per 1000)Hospital Bed Day rate

3.To determine if the cause of death varies by deprivation score. Aims

Deprivation Decile 1Deprivation Decile 10 Standardised* Mortality rate (per 1000) 2002, by Cause, 95% C.I. *Standardised to 1991 New Zealand Population

4.To determine if the cause of hospital use varies by deprivation score. Aims

Deprivation Decile 1Deprivation Decile 10 Standardised* Hospital Bed Day rate (per 1000) 2002, by Cause, 95% C.I. *Standardised to 1991 New Zealand Population

Results 1 & 2. Mortality and hospital bed day rates amongst the oldest ages (80+) do not vary substantially by deprivation decile, the overall differential is driven by younger ages (50 to 75). 3.The cause of mortality does not vary substantially by deprivation score. 4.The cause of hospital use does vary slightly by deprivation score

Discussion

New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

Standardised* Mortality Rates by Age, 2006 MaleFemale *Standardised to 1991 New Zealand Population

Standardised* Hospital Bed Day Rates by Age, 2006 MaleFemale *Standardised to 1991 New Zealand Population

Further Work? Log-linear analysis Avoidable/non-Avoidable Private health sector Ethnicity Compression of morbidity