1. Cause-specific hospital utilisation and mortality patterns in New Zealand by area deprivation, 1974-2006 Ngaire Coombs Zoë Matthews, Sabu Padmadas Division of Social Statistics, School of Social Sciences, University of Southampton

3. New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

4. Aims Data Results Discussion Further Work? Outline

5. 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.

6. Mortality 1974-2006* (800,000 events) Hospital Discharges 1974-2007 (20 million events) NZDep Area deprivation score 1991, 1996, 2001, 2006 National analyses 1974-2006 Sub-national analyses (by deprivation) 1991-2006 Data *Excluding 2001

7. Hospital Discharges, 1974-2007Hospital Bed Days, 1974-2007

8. Hospital Discharges, 1974-2007Hospital Bed Days, 1974-2007

9. Filtering of Hospital Data

10. Hospital Discharges, 1974-2007Hospital Bed Days, 1974-2007

11. Hospital Discharges, 1974-2007Hospital Bed Days, 1974-2007

12. Results

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

14. 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

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

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

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

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

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

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

21. 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

22. Discussion

23. New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

24. New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

25. New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

26. New Zealand Population, 2002 Deprivation Decile 1Deprivation Decile 10

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

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

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