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