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Hospitalisation

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Hospitalisation

Separation rates9

During 2011-12, there were 1,024,462 hospital separations in WA, of which 75,306 (7.4%) were identified as Indigenous [1]. 10 The age-standardised separation rate of 1,563 separations per 1,000 for Indigenous people was 3.8 times higher than the rate for other people in WA. Around 39% of the separations identified as Indigenous involved overnight hospital stays, and 60% were same-day acute separations (the details of a small number of the overall separations were not reported). The age-standardised separation rate for Indigenous people for overnight stays was 2.4 times the rate for non-Indigenous people. Excluding same-day separations for renal dialysis, for which rates were much higher for Indigenous people than for non-Indigenous people, the age-adjusted separation rate for same-day separations was 1.3 times higher for non-Indigenous people than for Indigenous people

Age-specific separation rates

In WA in 2008-10, separation rates were higher for Indigenous people than those for non-Indigenous people for all age-groups, except the 65 years and older age-group; the highest disparities occurred in the middle adult years (Table 5) [2].

Table 5: Age-specific hospital separation rates (excluding dialysis), by Indigenous status and sex, and Indigenous:non-Indigenous rate ratios, WA, 2008-10
Age-group (years) Males Females Persons
Indigenous Non-Indigenous Rate ratio Indigenous Non-Indigenous Rate ratio Indigenous Non-Indigenous Rate ratio
Source: AIHW, 2013 [2]
Notes:
  1. Numbers include separations for which Indigenous status was not stated
  2. Rates are expressed as separations per 1,000 population
  3. Rate ratio is the Indigenous rate divided by the non-Indigenous rate
  4. Rate ratios for ‘All ages’ are directly age-standardised using the 2001 Australian standard population (*)
0-4 438 246 1.8 367 181 2.0 403 214 1.9
5–14 137 93 1.5 108 75 1.4 123 85 1.5
15–24 188 132 1.4 432 228 1.9 306 178 1.7
25–34 272 142 1.9 595 355 1.7 430 245 1.8
35–44 464 188 2.5 575 324 1.8 520 255 2.0
45–54 580 273 2.1 579 331 1.7 580 302 1.9
55–64 676 457 1.5 709 447 1.6 693 452 1.5
65+ 855 920 0.9 800 764 1.0 824 837 1.0
All ages 329 290 1.5* 436 349 1.6* 382 319 1.5*

Causes of hospitalisation

In 2008-10, the most common cause of hospitalisation among Indigenous people living in WA was for the International Classification of Diseases (ICD) group ‘Care involving dialysis’ (Table 6) [2]. (Many of these separations involved repeat admissions for the same people, some on an almost daily basis.) After age-adjustment, the rate of 764 per 1,000 for Indigenous people was almost 16 times higher than the rate for non-Indigenous people. After excluding dialysis, ICD ‘Injury, poisoning and certain other consequences of external causes’ (including motor vehicle accidents, assaults, self-inflicted harm and falls) was the next most common cause of hospitalisation for Indigenous people, with an Indigenous rate of 65 per 1,000 which was 2.9 times higher than the non-Indigenous rate. The next leading cause of hospitalisation for Indigenous people was for respiratory conditions with an Indigenous rate of 56 per 1,000 which was 4.0 times higher than the non-Indigenous rate.

Table 6: Age-standardised hospital separation rates, by principal diagnosis and Indigenous status, and Indigenous:non-Indigenous rate ratios, WA, 2008-10
Principal diagnosis Indigenous Non-Indigenous Rate ratio
Source: Derived from AIHW, 2013 [2]
Notes:
  1. Numbers include separations for which Indigenous status was not stated
  2. Rates are expressed as separations per 1,000 population and directly age-standardised using the 2001 Australian standard population
  3. Rate ratio is the Indigenous rate divided by the non-Indigenous rate
Injury, poisoning and certain other consequences of external causes 65 23 2.9
Disease of the respiratory system 56 14 4.0
Disease of the digestive system 38 39 1.0
Symptoms, signs and abnormal clinical and laboratory findings 37 23 1.6
Disease of the circulatory system 36 19 1.9
Pregnancy, childbirth and the puerperium 35 21 1.6
Mental and behavioural disorders 33 13 2.6
Endocrine, nutritional and metabolic diseases 29 8.6 3.4
Disease of the genitourinary system 23 16 1.4
Disease of the skin and subcutaneous tissue 19 5.7 3.3
Certain infectious and parasitic diseases 14 4.8 2.9
Other 96 129 0.7
Care involving dialysis 764 49 15.5
Total 1,245 364 3.4

Endnotes

  1. ‘Separation’ refers to an episode of admitted patient care, which can be either a patient’s total stay in hospital or part of a patient’s stay in hospital that results in a change to the type of care (e.g. from acute to rehabilitation). Hospital separations are more widely known as ‘admissions’, but can also be referred to as ‘hospitalisations’.
  2. The overall level of identification of Indigenous people in WA’s public hospitals was very good at 96%, but the level was only 90% for admissions in inner regional and remote areas.

References

  1. Australian Institute of Health and Welfare (2013) Australian hospital statistics 2011–12. Canberra: Australian Institute of Health and Welfare
  2. Australian Institute of Health and Welfare (2013) Aboriginal and Torres Strait Islander health performance framework 2012 report: Western Australia supplementary tables. Canberra: Australian Institute of Health and Welfare
 
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