S Cournane1, R Conway2, D Byrne2, D O'Riordan2, S Coveney3, B Silke2. 1. From the Medical Physics and Bioengineering Department, St James's Hospital, Dublin 8, Ireland scournane@stjames.ie. 2. Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland. 3. School of Geographical and Earth Sciences, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.
Abstract
BACKGROUND: Deprivation Status increases the annual admission incidence of emergency medical admissions; the extent to which deprivation influences the admission of older persons is less well known. AIM: To examine whether deprivation within a hospital catchment area influences emergency medical admissions for the elderly population. DESIGN: The relationship between Deprivation Status, Dependency Ratio (population proportion of non-working age (<15 or ≥65 years) and age for all emergency admissions (82 368 episodes of 44 628 patients), over a 13-year period, were examined and ranked by quintile. METHODS: Univariate and multi-variable risk estimates (incidence rate ratios) were calculated, using truncated Poisson regression. RESULTS: The Dependency Ratio and the Deprivation index independently predicted the annual incidence rate of medical emergencies; however, when calculated for older persons, the corresponding incidence rate ratios showed a falling trend with increasing Deprivation Status-Q2 0.51 (95% confidence interval [CI]: 0.50, 0.52), Q3 0.59 (95% CI: 0.58, 0.60), Q4 0.51 (95% CI: 0.50, 0.52) and Q5 0.37 (95% CI: 0.36, 0.38). Thus, with increasing Deprivation Status, the proportion of total admission from the ≥65-year cohort fell substantially. CONCLUSION: The admission incidence rate for emergency medical patients is strongly influenced by the catchment area Deprivation Status. However, because of its greater impact on the younger population, increasing deprivation alters the ratio of younger to older persons as a proportion of total emergency admissions.
BACKGROUND: Deprivation Status increases the annual admission incidence of emergency medical admissions; the extent to which deprivation influences the admission of older persons is less well known. AIM: To examine whether deprivation within a hospital catchment area influences emergency medical admissions for the elderly population. DESIGN: The relationship between Deprivation Status, Dependency Ratio (population proportion of non-working age (<15 or ≥65 years) and age for all emergency admissions (82 368 episodes of 44 628 patients), over a 13-year period, were examined and ranked by quintile. METHODS: Univariate and multi-variable risk estimates (incidence rate ratios) were calculated, using truncated Poisson regression. RESULTS: The Dependency Ratio and the Deprivation index independently predicted the annual incidence rate of medical emergencies; however, when calculated for older persons, the corresponding incidence rate ratios showed a falling trend with increasing Deprivation Status-Q2 0.51 (95% confidence interval [CI]: 0.50, 0.52), Q3 0.59 (95% CI: 0.58, 0.60), Q4 0.51 (95% CI: 0.50, 0.52) and Q5 0.37 (95% CI: 0.36, 0.38). Thus, with increasing Deprivation Status, the proportion of total admission from the ≥65-year cohort fell substantially. CONCLUSION: The admission incidence rate for emergency medical patients is strongly influenced by the catchment area Deprivation Status. However, because of its greater impact on the younger population, increasing deprivation alters the ratio of younger to older persons as a proportion of total emergency admissions.
Authors: Joyce J H Wachelder; Isabelle van Drunen; Patricia M Stassen; Steffie H A Brouns; Suze L E Lambooij; Mieke J Aarts; Harm R Haak Journal: BMJ Open Date: 2017-12-26 Impact factor: 2.692