joint strategic needs assessment foundation profile - JSNA

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10.13.2.2 Inpatient Admissions in Relation to Deprivation
Figure 250 illustrates the average annual directly age-standardised daycase and
inpatient admission rates which involve a primary diagnosis of fractured neck of femur
(any clinician episode within that hospital stay) by local deprivation quintile over three
financial years 2006/07 to 2008/09 (standardised to European Standard Population) for
those aged 65+ years. The admissions do not necessarily relate to those caused by
falls, but it is likely that many of the fractured neck of femurs in those aged 65+ years
results from falls with the other main cause probably being car accidents. The 95%
confidence intervals are shown. There is a statistically significant difference among the
quintiles for daycase and inpatient admissions for fractured neck of femurs for those
aged 65+ years. The standardised admission rate in the most deprived quintile is 986
admissions per 100,000 people aged 65+ years compared to 743 per 100,000 people
aged 65+ years in the least deprived quintiles. So whilst there is a higher admission rate
in the most deprived areas, the trend across the five quintiles is not consistent with the
second most derived quintile having the lowest admission rates. However, it is difficult to
ascertain if this trend across the quintiles is reflecting „need‟. The underlying data are
given in the APPENDIX on page 943. People living in the most deprived areas will tend to
have higher levels of poor health generally and morbidity which could influence mobility
and the likelihood of falls. There could also be different levels of carer and support
available, as well as the installation of mobility aids. All these factors could influence the
likelihood of falls in those aged 65+ years. There may also be a difference in the
prevalence of osteoporosis among the deprivation quintiles which will be a strong predictor
of whether a falls results in a fractured neck of the femur.
Figure 250: Age-gender standardised inpatient hospital admission rate for fracture neck
of the femur in those persons aged 65+ years by local deprivation quintile
Annual average DSR per 100,000 per
persons aged 65+ for fractured neck
of the femur
1200
1000
800
600
400
200
0
Most
deprived
quintile
Quintile 2 Quintile 3 Quintile 4 Least
deprived
quintile
Index of Multiple Deprivation 2007 local quintile
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 757