Ngaire Coombs Zo ë Matthews, Sabu Padmadas

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 1 Deprivation Decile 10

4. Outline • Aims • Data • Results • Discussion • Further Work?

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

6. Data 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 *Excluding 2001

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

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

9. Filtering of Hospital Data

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

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

12. Results

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

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

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

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

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

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

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

20. Standardised* Hospital Bed Day rate (per 1000) 2002, by Cause, 95% C.I. Deprivation Decile 1 Deprivation Decile 10 *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). • The cause of mortality does not vary substantially by deprivation score. • The cause of hospital use does vary slightly by deprivation score

22. Discussion

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

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

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

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

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

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

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