Hospital Events 2007/08

Transcription

1 Hospital Events 2007/08

2 Citation: Ministry of Health Hospital Events 2007/08. Wellington: Ministry of Health. Published in December 2011 by the Ministry of Health PO Box 5013, Wellington 6145, New Zealand ISBN (print) ISBN (online) HP 5426 This document is available on the Ministry of Health s website:

3 Acknowledgements Many people have assisted in the production of this publication. In particular, the Ministry of Health thanks the peer reviewers for their valuable contribution. Source Hospital data for this publication are sourced from the National Minimum Dataset (Hospital Events) held by the Ministry of Health. Copyright The copyright owner of this publication is the Ministry of Health, which is part of the New Zealand Crown. The Ministry of Health permits the reproduction of material from this publication without prior notification, provided that all following conditions are met: the content is not distorted or changed the information is not sold the material is not used to promote or endorse any product or service the material is not used in an inappropriate or misleading context having regard to the nature of the material any relevant disclaimers, qualifications or caveats included in the publication are reproduced the Ministry of Health is acknowledged as the source. Disclaimer The purpose of this publication is to inform discussion and assist policy development. The opinions expressed in the publication do not necessarily reflect the official views of the Ministry of Health. All care has been taken in the production of this publication. The data are deemed to be accurate at the time of publication, but may be subject to slight changes over time as further information is received. It is advisable to check the current status of figures given here with the Ministry of Health before quoting or using them in further analysis. National collection, coding and collation of hospital event data is a complex process. This is because the information in the National Minimum Dataset cannot be finalised until data have become available from all hospitals that report to the Ministry of Health. In addition, several steps are required to ensure the final information is of good quality. The Ministry of Health makes no warranty, expressed or implied, nor assumes any legal liability or responsibility for the accuracy, correctness, completeness or use of the information or data in this publication. Further, the Ministry of Health shall not be liable for any loss or damage arising directly or indirectly from the information or data presented in this publication. The Ministry of Health welcomes comments and suggestions about this publication. Hospital Events 2007/08 iii

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5 Contents Selected Facts xi Introduction 1 Data sources, data quality and timing issues 2 Hospital Discharges 4 Overview 4 Sex 6 Age 8 Ethnicity 13 Deprivation 19 District Health Board region 21 Selected diagnoses 27 Length of stay and bed days 33 Inpatients and day cases 39 Hospital Procedures 49 Overview 49 Sex 51 Age 53 Ethnicity 58 Deprivation 64 District Health Board region 66 Selected procedures 72 Length of stay 77 Inpatients and day cases 80 Hospital Discharges Involving Injury and Poisoning 90 Overview 90 Sex 92 Age 94 Ethnicity 97 Deprivation 103 District Health Board region 105 Selected causes 111 Length of stay and bed days 112 Inpatients and day cases 117 Definitions 125 Technical Notes 128 Rate calculations 128 Confidence intervals 129 References 131 Hospital Events 2007/08 v

6 List of Tables Table 1: Hospital discharges by hospital type and funding type, 2004/ /08 1 Table 2: Hospital discharges and age-standardised rates, 1995/ /08 4 Table 3: Hospital discharges and age-standardised rates by sex, 1995/ /08 6 Table 4: Publicly funded hospital discharges by five-year age group and sex, 2007/08 8 Table 5: Privately funded hospital discharges by five-year age group and sex, 2007/08 9 Table 6: Average age at discharge from hospital, 1995/ /08 10 Table 7: Publicly funded hospital discharges and age-standardised rates by ethnicity, 1995/ /08 13 Table 8: Publicly funded hospital discharges and age-standardised rates by ethnicity and sex, 1995/ /08 15 Table 9: Publicly funded hospital discharges by DHB region, 2007/08 21 Table 10: Publicly funded hospital discharges by DHB region, Māori population, 2007/08 24 Table 11: Age-standardised publicly funded hospital discharge rates for selected diagnoses by sex and ethnicity, 2007/08 29 Table 12: Age-standardised privately funded hospital discharge rates for selected diagnoses by sex, 2007/08 32 Table 13: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital discharges, 1995/96 and 2007/08 34 Table 14: Average length of stay and total bed days by sex, privately funded hospital discharges, 2004/05 and 2007/08 34 Table 15: Average length of stay and total bed days by DHB region, total population, publicly funded hospital discharges, 2007/08 37 Table 16: Average length of stay and total bed days by DHB region, Māori population, publicly funded hospital discharges, 2007/08 38 Table 17: Hospital discharges by patient type, 1995/ /08 39 Table 18: Hospital discharges by five-year age group and patient type, 2007/08 41 Table 19: Publicly funded hospital discharges by five-year age group, ethnicity and patient type, 2007/08 44 Table 20: Hospital procedures and age-standardised rates, 1995/ /08 49 Table 21: Hospital procedures by sex, 1995/ /08 51 Table 22: Publicly funded hospital procedures by five-year age group and sex, 2007/08 53 Table 23: Privately funded hospital procedures by five-year age group and sex, 2007/08 54 Table 24: Average age at hospital procedure, 1995/ /08 55 Table 25: Publicly funded hospital procedures and age-standardised rates by ethnicity, 1995/ /08 58 Table 26: Publicly funded hospital procedures and age-standardised rates by ethnicity and sex, 1995/ /08 60 Table 27: Publicly funded hospital procedures by DHB region, 2007/08 66 Table 28: Publicly funded hospital procedures by DHB region, Māori population, 2007/08 69 Table 29: Age-standardised publicly funded hospital procedure rates for selected procedures by sex and ethnicity, 2007/08 73 Table 30: Age-standardised privately funded hospital procedure rates for selected procedures by sex, 2007/08 76 Table 31: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital procedures, 1995/96 and 2007/08 77 Table 32: Average length of stay and total bed days by sex and ethnicity, privately funded hospital procedures, 2004/05 and 2007/08 77 Table 33: Average length of stay by ethnicity and DHB region, publicly funded hospital procedures, 2007/08 79 vi Hospital Events 2007/08

7 Table 34: Hospital procedures by patient type, 1995/ /08 80 Table 35: Hospital procedures by five-year age group and patient type, 2007/08 82 Table 36: Publicly funded hospital procedures by five-year age group, ethnicity and patient type, 2007/08 85 Table 37: Hospital discharges involving injury and poisoning and age-standardised rates, 1995/ /08 90 Table 38: Hospital discharges involving injury and poisoning and age-standardised rates by sex, 1995/ /08 92 Table 39: Hospital discharges involving injury and poisoning by five-year age group and sex, 2007/08 94 Table 40: Average age at hospitalisation, hospital discharges involving injury and poisoning, 1995/ /08 95 Table 41: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity, 1995/ /08 97 Table 42: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity and sex, 1995/ /08 99 Table 43: Hospital discharges involving injury and poisoning by DHB region, 2007/ Table 44: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2007/ Table 45: Age-standardised rates for hospital discharges involving injury and poisoning for selected causes by sex and ethnicity, 2007/ Table 46: Average length of stay and total bed days by sex and ethnicity, hospital discharges involving injury and poisoning, 1995/96 and 2007/ Table 47: Average length of stay and total bed days by DHB region, total population, hospital discharges involving injury and poisoning, 2007/ Table 48: Average length of stay and total bed days by DHB region, Māori population, hospital discharges involving injury and poisoning, 2007/ Table 49: Hospital discharges involving injury and poisoning by patient type, 1995/ / Table 50: Hospital discharges involving injury and poisoning by five-year age group and patient type, 2007/ Table 51: Hospital discharges involving injury and poisoning by five-year age group, ethnicity and patient type, 2007/ Table N-1: World Health Organization world standard population 128 Table N-2: Population data, 2007/ Table N-3: ICD-10-AM 3rd Edition procedure codes for selected procedures 130 Hospital Events 2007/08 vii

8 List of Figures Figure 1: Age-standardised hospital discharge rates, 1995/ /08 5 Figure 2: Age-standardised hospital discharge rates by sex, 1995/ /08 7 Figure 3: Age-specific publicly funded hospital discharge rates by sex, 2007/08 11 Figure 4: Age-specific privately funded hospital discharge rates by sex, 2007/08 12 Figure 5: Age-standardised publicly funded hospital discharge rates by ethnicity, 1995/ /08 14 Figure 6: Age-specific publicly funded hospital discharge rates by ethnicity, 2007/08 16 Figure 7: Age-specific publicly funded hospital discharge rates by ethnicity, males, 2007/08 17 Figure 8: Age-specific publicly funded hospital discharge rates by ethnicity, females, 2007/08 18 Figure 9: Publicly and privately funded hospital discharge rates by deprivation quintile, 2007/08 19 Figure 10: Publicly funded hospital discharge rates by ethnicity and deprivation quintile, 2007/08 20 Figure 11: Publicly funded hospital discharge rates by DHB region, 2007/08 22 Figure 12: Publicly funded hospital discharge rates by DHB region, 2007/08 23 Figure 13: Publicly funded hospital discharge rates by DHB region, Māori population, 2007/08 25 Figure 14: Publicly funded hospital discharge rates by DHB region, Māori population, 2007/08 26 Figure 15: Publicly funded hospital discharges by sex and ICD chapter, 2007/08 27 Figure 16: Privately funded hospital discharges by sex and ICD chapter, 2007/08 31 Figure 17: Average length of stay and total bed days by deprivation quintile, publicly funded hospital discharges, 2007/08 35 Figure 18: Average length of stay and total bed days by deprivation quintile, privately funded hospital discharges, 2007/08 36 Figure 19: Publicly funded hospital discharges by patient type, 1995/ /08 40 Figure 20: Age-specific publicly funded hospital discharge rates by patient type, 2007/08 42 Figure 21: Age-specific privately funded hospital discharge rates by patient type, 2007/08 43 Figure 22: Age-specific publicly funded hospital discharge rates by ethnicity, inpatients, 2007/08 45 Figure 23: Age-specific publicly funded hospital discharge rates by ethnicity, day cases, 2007/08 46 Figure 24: Publicly funded hospital discharges by deprivation quintile and patient type, 2007/08 47 Figure 25: Privately funded hospital discharges by deprivation quintile and patient type, 2007/08 48 Figure 26: Age-standardised hospital procedure rates, 1995/ /08 50 Figure 27: Age-standardised hospital procedure rates by sex, 1995/ /08 52 Figure 28: Age-specific publicly funded hospital procedure rates by sex, 2007/08 56 Figure 29: Age-specific privately funded hospital procedure rates by sex, 2007/08 57 Figure 30: Age-standardised hospital procedure rates by ethnicity, 1995/ /08 59 Figure 31: Age-specific publicly funded hospital procedure rates by ethnicity, 2007/08 61 Figure 32: Age-specific publicly funded hospital procedure rates by ethnicity, males, 2007/08 62 Figure 33: Age-specific publicly funded hospital procedure rates by ethnicity, females, 2007/08 63 Figure 34: Publicly and privately funded procedure discharge rates by deprivation quintile, 2007/08 64 Figure 35: Publicly funded hospital procedure rates by ethnicity and deprivation quintile, 2007/08 65 Figure 36: Publicly funded hospital procedure rates by DHB region, 2007/08 67 Figure 37: Publicly funded hospital procedure rates by DHB region, 2007/08 68 Figure 38: Publicly funded hospital procedure rates by DHB region, Māori population, 2007/08 70 Figure 39: Publicly funded hospital procedure rates by DHB region, Māori population, 2007/08 71 Figure 40: Publicly funded hospital procedures by sex and ICD chapter, 2007/08 72 Figure 41: Privately funded hospital procedures by sex and ICD chapter, 2007/08 75 Figure 42: Average length of stay, hospital procedures, 2007/08 78 viii Hospital Events 2007/08

9 Figure 43: Publicly funded hospital procedures by patient type, 1995/ /08 81 Figure 44: Age-specific publicly funded hospital procedure rates by patient type, 2007/08 83 Figure 45: Age-specific privately funded hospital procedure rates by patient type, 2007/08 84 Figure 46: Age-specific publicly funded hospital procedure rates by ethnicity, inpatients, 2007/08 86 Figure 47: Age-specific publicly funded hospital procedure rates by ethnicity, day cases, 2007/08 87 Figure 48: Publicly funded hospital procedures by deprivation quintile and patient type, 2007/08 88 Figure 49: Privately funded hospital procedures by deprivation quintile and patient type, 2007/08 89 Figure 50: Age-standardised hospital discharge rates involving injury and poisoning, 1995/ /08 91 Figure 51: Age-standardised hospital discharge rates involving injury and poisoning by sex, 1995/ /08 93 Figure 52: Age-specific rates for hospital discharges involving injury and poisoning by sex, 2007/08 96 Figure 53: Age-standardised rates for hospital discharges involving injury and poisoning by ethnicity, 1995/ /08 98 Figure 54: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, 2007/ Figure 55: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, males, 2007/ Figure 56: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, females, 2007/ Figure 57: Rates for hospital discharges involving injury and poisoning by deprivation quintile, 2007/ Figure 58: Rates for hospital discharges involving injury and poisoning by ethnicity and deprivation quintile, 2007/ Figure 59: Hospital discharges involving injury and poisoning by DHB region, 2007/ Figure 60: Hospital discharges involving injury and poisoning by DHB region, 2007/ Figure 61: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2007/ Figure 62: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2007/ Figure 63: Average length of stay and total bed days by deprivation quintile, hospital discharges involving injury and poisoning, 2007/ Figure 64: Hospital discharges involving injury and poisoning by patient type, 1995/ / Figure 65: Age-specific rates for hospital discharges involving injury and poisoning by patient type, 2007/ Figure 66: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2007/ Figure 67: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2007/ Figure 68: Hospital discharges involving injury and poisoning by deprivation quintile and patient type, 2007/ Hospital Events 2007/08 ix

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11 Selected Facts Below is a summary of hospital discharges, hospital procedures and hospital discharges involving injury and poisoning from New Zealand hospitals from 1995/96 to 2007/08. Overview There were 1,005,305 discharges from New Zealand hospitals in 2007/08 (21,881.6 hospital discharges per 100,000 population (age-standardised)). There were 1,397,692 procedures performed in New Zealand hospitals in 2007/08 (30,373.7 hospital procedures per 100,000 population (age-standardised)). There were 158,912 discharges involving injury and poisoning from New Zealand hospitals in 2007/08 ( hospital discharges per 100,000 population (agestandardised)). Sex In 2007/08, females had higher age-standardised rates of hospital discharges and hospital procedures compared with males, while males had a higher rate of hospitalisations involving injury and poisoning compared with females. Age Older patients (aged 65 years and over) generally had higher age-specific rates of hospital discharges, hospital procedures and hospitalisations involving injury and poisoning in 2007/08. Young patients (aged 0 4 years) also had high hospital discharge rates in 2007/08. Privately funded patients were older, on average, than publicly funded patients in 2007/08. Ethnicity Māori accounted for 16.5 percent (153,523) of all publicly funded hospital discharges, 15.9 percent (198,316) of all publicly funded procedures and 14.6 percent (23,162) of all hospital discharges involving injury and poisoning in 2007/08. Māori had higher rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning compared with non-māori in each year from 1995/96 to 2007/08. Deprivation As deprivation increased, rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning increased in 2007/08. Conversely, as deprivation increased, privately funded hospital discharge and hospital procedure rates decreased in 2007/08. Hospital Events 2007/08 xi

12 At all levels of deprivation, rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning were almost always significantly higher for Māori compared with non-māori in 2007/08. District Health Board region Northland District Health Board (DHB) region had the highest age-standardised rates of publicly funded hospital discharges and hospital procedures in 2007/08, while Tairawhiti had the highest rate of hospitalisations involving injury and poisoning. Capital & Coast DHB region had the lowest age-standardised rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning in 2007/08. Selected diagnoses and procedures Māori had higher publicly funded hospitalisation rates (including hospitalisations involving injury and poisoning) compared with non-māori for most selected diagnoses in 2007/08. Māori had higher hospital procedure rates than non-māori for most selected publicly funded procedures in 2007/08. Length of stay and bed days The average length of stay in hospital increased for publicly funded hospital discharges and decreased for publicly funded hospital procedures and hospitalisations involving injury and poisoning from 1995/96 to 2007/08. On average, non-māori hospitalisations (including those involving injury and poisoning) were longer compared with Māori in 2007/08. However, for hospital procedures, Māori spent longer (on average) in hospital compared with non-māori. From 1995/96 to 2007/08, the total number of bed days increased by 56.9 percent for publicly funded hospital discharges and 44.3 percent for hospitalisations involving injury and poisoning. Inpatients and day cases Day cases made up approximately one-third of publicly funded hospital discharges, one-third of publicly funded hospital procedures and one in five hospitalisations involving injury and poisoning in 2007/08. Day cases made up more than half of privately funded hospital discharges (57.8%) and privately funded hospital procedures (55.3%) in 2007/08. xii Hospital Events 2007/08

13 Introduction This publication contains statistical information about events 1 in New Zealand hospitals including: discharges (hospitalisations) from publicly and privately owned facilities procedures performed in publicly and privately owned facilities discharges involving injury and poisoning. The publication covers both publicly and privately funded hospital events. Publicly funded events 2 can occur in public or private hospitals, just as privately funded events can occur in private or public hospitals. Table 1 illustrates this point. Table 1: Hospital discharges by hospital type and funding type, 2004/ /08 Year Hospital type Number Funding type Hospital type Percent of total discharges Funding type Public Private Public Private 2004/ / / /08 Public 812,566 2,944 Public Private 57,786 83,903 Private Public 837,983 2,743 Public Private 55,254 80,868 Private Public 864,405 3,082 Public Private 61,388 78,721 Private Public 867,932 3,550 Public Private 65,211 68,612 Private For the four years to 30 June 2008, the majority of discharges from public hospitals were publicly funded. Over half of reported discharges from private hospitals 3 were privately funded. It is important to note that the private hospital data in this publication is not complete, as not all private hospitals report their data to the Ministry of Health. The following section provides information on the quality of hospital data Hospital events include those involving New Zealand and overseas residents treated in New Zealand. Publicly funded events include Accident Compensation Corporation (ACC), DHB and Ministry of Health funded events. In this publication, private hospitals include private surgical hospitals and private aged care facilities. Hospital Events 2007/08 1

14 Data sources, data quality and timing issues The information presented in this publication is reported by financial year ended 30 June. For example, the 2007/08 financial year relates to the period from 1 July 2007 to 30 June The National Minimum Dataset The data in this publication is from the NMDS, a national collection of public and private hospital discharge information (including clinical information) for inpatients and day patients. The NMDS collects and stores unit record data. It is important to note that hospital events recorded in the NMDS represent individual events rather than individual people. The number of events will be higher than the number of people, because a single person can contribute numerous unique hospital events to the dataset. Quality of publicly funded hospital data This publication contains publicly funded hospital data for the financial years from 1995/96 to 2007/08 (1 July 1995 to 30 June 2008). Improvements in the recording and reporting of data from July 1995 have enabled meaningful analysis from this point forward. Quality of privately funded hospital data This publication contains privately funded hospital data for the financial years from 2004/05 to 2007/08 (1 July 2004 to 30 June 2008). Data has been used from 2004/05 onwards because the completeness of privately funded and privately provided hospital data improved from this point forward. The privately funded hospital data included in this publication are not complete, as not all private hospitals report their data to the Ministry of Health. For example, in 2007 four hospitals reported no data, and eight hospitals sent data to the Ministry of Health with some months missing. In 2008, five hospitals reported no data and one hospital reported incomplete data. The Ministry of Health has no means of accurately assessing the number and nature of discharge data that are not reported. For these reasons, regional comparisons of privately funded hospital data are not included in this publication. Other aspects affecting the quality of privately funded data are ethnicity and diagnosis information. Ethnicity data for private hospitals have not been included in this publication due to the high number of events that have no ethnicity information recorded. Diagnosis information is more complete for medical discharges than for surgical data due to more complete reporting. The strengths of the privately funded hospital data include procedure information, length of stay and patient details. In summary, care should be taken when analysing the privately funded hospital data in this publication, because they do not present a complete dataset. 2 Hospital Events 2007/08

15 Timing of data The timeliness of all hospital discharge information is improving, and will continue to do so. The Ministry of Health conducts data quality work after public and private hospital data is coded. Once this process is complete, provisional hospital data is made available via the Ministry of Health s website. Further information on hospital events, including datasets, can be found online ( Other publications containing data from the NMDS Other Ministry of Health publications that report data from the NMDS are: Hospital-based Maternity Events ( Suicide Facts: Deaths and Intentional Self-harm Hospitalisations ( Hospital Events 2007/08 3

16 Hospital Discharges This chapter presents statistics on discharges from publicly and privately funded New Zealand hospitals. Overview There were 1,005,305 discharges 4 from New Zealand hospitals in 2007/08. This represents an age-standardised rate of 21,881.6 hospital discharges per 100,000 population. 5 Table 2 shows the number of hospital discharges and age-standardised rates for the period from 1 July 1995 to 30 June Table 2: Hospital discharges and age-standardised rates, 1995/ /08 Year Publicly funded discharges Privately funded discharges Total discharges Number Rate Number Rate Number Rate 1995/96 649,491 16, /97 651,931 16, /98 681,022 17, /99 704,195 17, /00 744,422 18, /01 799,973 19, /02 822,386 19, /03 828,195 19, /04 846,060 19, /05 870,352 19, , ,199 21, /06 893,237 20, , ,848 21, /07 925,793 20, , ,007,596 22, /08 933,143 20, , ,005,305 21,881.6 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. Publicly funded hospital discharges made up the majority of total hospital discharges. In 2007/08, 92.8 percent of hospital discharges were publicly funded. 4 5 Hospital discharges (hospitalisations) include day patients, transfers and readmissions. An age-standardised rate is a rate that has been adjusted to take account of differences in the age distribution of the population over time or between different groups (for example, different ethnic groups). This publication has used the WHO world standard population in determining agestandardised rates. For more information on rates refer to the Definitions section of this publication. 4 Hospital Events 2007/08

17 The number of publicly funded hospital discharges (hospitalisations) increased over time, while the number of reported privately funded hospitalisations decreased. From 1995/96 to 2007/08, the number of publicly funded hospitalisations increased by 43.7 percent. From 2004/05 to 2007/08, the number of reported privately funded hospitalisations decreased by 16.9 percent. Table 2 and Figure 1 also show how the rate of hospitalisations has changed over time. Accounting for changes in the New Zealand population, Figure 1 shows that the rate of publicly funded hospitalisations increased by 18.8 percent from 1995/96 to 2001/02. From 2001/02 to 2007/08 the rate remained relatively stable, at around 20,000 publicly funded hospitalisations per 100,000 population. The rate of privately funded hospitalisations decreased by 20.9 percent from 2004/05 to 2007/08. Figure 1: Age-standardised hospital discharge rates, 1995/ /08 25,000 Age-standardised rate 20,000 15,000 10,000 5,000 Publicly funded hospital discharges Privately funded hospital discharges / / / / / / / / / / / / /08 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. It is more common for publicly funded patients to be hospitalised more than once in any given year compared with privately funded patients percent (533,933) of publicly funded hospitalisations were for patients who were hospitalised more than once (in either a public or private hospital) in 2007/08. In the same year, 18.6 percent (13,390) of privately funded hospitalisations were for patients who were hospitalised more than once (in either a private or public hospital). Year Hospital Events 2007/08 5

18 Sex The table below shows the number of hospital discharges and age-standardised rates by sex from 1 July 1995 to 30 June There were 560,431 female hospital discharges (24,205.9 per 100,000 female population) and 444,874 male hospital discharges (19,503.4 per 100,000 male population) in 2007/08. Each year more females than males were discharged from New Zealand hospitals. Females accounted for 55.7 percent of all publicly funded and privately funded hospitalisations in 2007/08. A large proportion of female hospitalisations are maternityrelated events (almost 20%). Please refer to the Selected diagnoses section for further information. Table 3: Hospital discharges and age-standardised rates by sex, 1995/ /08 Year Publicly funded discharges Privately funded discharges Total discharges Male Female Male Female Male Female No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate 1995/96 276,640 14, ,851 18, /97 279,101 14, ,830 18, /98 294,257 15, ,765 19, /99 306,649 15, ,546 19, /00 323,471 16, ,951 20, /01 349,893 17, ,080 21, /02 364,087 17, ,298 21, /03 366,426 17, ,769 21, /04 373,481 17, ,579 21, /05 387,223 18, ,129 21, , , ,532 19, ,667 23, /06 398,381 18, ,856 21, , , ,030 19, ,818 23, /07 411,247 18, ,546 22, , , ,266 20, ,330 24, /08 412,668 18, ,475 22, , , ,874 19, ,431 24,205.9 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. 6 Hospital Events 2007/08

19 Figure 2 shows that the rate of publicly funded hospitalisations for females increased by 20.3 percent from 1 July 1995 to 30 June For the same time period, the rate of publicly funded hospitalisations for males increased by 24.1 percent, despite a drop in the rate in 2007/08. For privately funded facilities, the hospitalisation rate for females and males decreased by 19.3 and 22.8 percent respectively from 2004/05 to 2007/08. Figure 2: Age-standardised hospital discharge rates by sex, 1995/ /08 25,000 Age-standardised rate 20,000 15,000 10,000 5,000 0 Male publicly funded hospital discharges Female publicly funded hospital discharges Male privately funded hospital discharges Female privately funded hospital discharges 1995/ / / / / / / / / / / / /08 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. Year Hospital Events 2007/08 7

20 Age Table 4 shows that the age group with the highest number of publicly funded hospital discharges in 2007/08 was 0 4-year-olds 6 (133,922 or 14.4% of total discharges), followed by year-olds (59,022 or 6.3% of total discharges). Those aged 85 years and over had the highest age-specific rate 7 of publicly funded hospitalisations in 2007/08. Of this age group, there were more than 91,000 male hospitalisations per 100,000 male population and almost 74,000 female hospitalisations per 100,000 female population. Table 4: Publicly funded hospital discharges by five-year age group and sex, 2007/08 Age group (years) Male Female Total Number Rate Number Rate Number Rate ,127 46, ,795 42, ,922 44, , , , , , , ,722 16, ,933 13, , ,850 24, ,560 17, , ,654 28, ,739 18, , ,899 31, ,697 21, ,012 10, ,322 23, ,334 17, ,346 12, ,405 14, ,751 13, ,715 13, ,726 13, ,441 13, ,920 16, ,628 15, ,548 15, ,484 20, ,386 18, ,870 19, ,196 26, ,393 21, ,589 23, ,427 35, ,579 28, ,006 31, ,047 46, ,650 39, ,697 42, ,927 64, ,095 49, ,022 56, ,627 75, ,536 61, ,163 67, ,971 91, ,628 73, ,599 79,408.3 All ages 412,668 19, ,475 23, ,143 21,859.1 Note 1: The rate shown is the age-specific rate per 100,000 of the population in each age group. Note 2: Hospital discharges for children aged 0 4 years include birth events. 6 7 Hospital discharges for children aged 0 4 years include birth events. Approximately one-third of hospital discharges for this age group were for live births in 2007/08. An age-specific rate refers to the frequency with which an event occurs relative to the number of people in a defined age group. In this publication age-specific rates are given in five-year age groups. 8 Hospital Events 2007/08

21 Table 5 shows that year-olds had the highest number of privately funded hospitalisations in 2007/08 (7021 or 9.7%), followed by the (6994) and (6391) year-old groups (9.7% and 8.9% respectively). This age-related trend has been present each year from 2004/05. The year age group had the highest age-specific rate of privately funded hospitalisations in 2007/08: hospitalisations per 100,000 population. Table 5: Privately funded hospital discharges by five-year age group and sex, 2007/08 Age group (years) Male Female Total Number Rate Number Rate Number Rate All ages 32, , , Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. Hospital Events 2007/08 9

22 Table 6 shows that the average age of a patient discharged from hospital has increased over time, possibly reflecting New Zealand s ageing population. For example, the average age of a publicly funded patient increased by almost five years from 1995/96 to 2007/08. On the whole: males discharged from hospital were older than females privately funded patients were older than publicly funded patients. Table 6: Average age at discharge from hospital, 1995/ /08 Year Publicly funded discharges Privately funded discharges Male Female Total Male Female Total 1995/ / / / / / / / / / / / / Hospital Events 2007/08

23 Figure 3 shows publicly funded hospital discharge rates by five-year age group and sex for 2007/08. Females showed higher hospitalisation rates than males for the age groups from years. 8 For males, with the exception of those aged 0 4 years, the rate of hospitalisations generally increased with age. For females, the same trend was present, with the addition of an increase in hospitalisation rates over the child-bearing years (15 49). For both males and females, the rate of hospitalisations peaked in the 85 years and over age group. Figure 3: Age-specific publicly funded hospital discharge rates by sex, 2007/08 100,000 90,000 Rate per 100,000 population Male Female 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10, Age group (years) Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. 8 For females aged years, hospitalisations relating to pregnancy and childbirth made up 43.3 percent of total publicly funded hospital discharges in 2007/08. Hospital Events 2007/08 11

24 Figure 4 shows privately funded hospitalisation rates by five-year age group and sex. The trends are similar to those evident for publicly funded hospitalisations in Figure 3, although females had higher privately funded hospitalisation rates than males up until the age of 59 years (compared to 49 years for publicly funded hospitalisations). The highest hospitalisation rate for males was in the year age group ( privately funded hospitalisations per 100,000 male population). For females, the highest rate was in the year age group ( privately funded hospitalisations per 100,000 female population). Figure 4: Age-specific privately funded hospital discharge rates by sex, 2007/ Rate per 100,000 population Male Female Age group (years) Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. 12 Hospital Events 2007/08

25 Ethnicity This section presents ethnicity data for publicly funded hospital discharges only. Ethnicity data for private hospitals cannot be included in this publication due to the high number of discharges that have no ethnicity information recorded (see the Data sources, data quality and timing issues section in the Introduction for further information). Publicly funded hospital discharges for Māori accounted for 16.5 percent (153,523) of total hospitalisations in 2007/08. According to Statistics New Zealand, Māori made up 15.1 percent of the New Zealand population at 30 June Table 7 shows that Māori had higher hospitalisation rates compared with non-māori for each year from 1995/96 to 2007/08. Furthermore, the hospitalisation rate for Māori showed a larger increase compared with non-māori over the 13 years to 30 June 2008 (36.9% and 19.3% respectively). Table 7: Publicly funded hospital discharges and age-standardised rates by ethnicity, 1995/ /08 Year Māori discharges Non-Māori discharges Number Rate Number Rate 1995/96 91,678 18, ,813 16, /97 93,997 19, ,934 16, /98 99,811 20, ,211 16, /99 104,661 20, ,534 17, /00 112,007 22, ,415 18, /01 123,037 23, ,936 19, /02 127,671 24, ,715 19, /03 132,726 24, ,469 18, /04 138,571 25, ,489 18, /05 143,919 26, ,433 19, /06 150,085 26, ,152 19, /07 154,931 27, ,862 19, /08 153,523 25, ,620 19,739.5 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. 9 See and Hospital Events 2007/08 13

26 Figure 5 shows that the greatest disparity between Māori and non-māori hospitalisation rates occurred in 2005/06. In this year, the rate for Māori was 39.5 percent higher than the rate for non-māori. In 2007/08, the publicly funded hospitalisation rate for Māori was 31.2 percent higher than the rate for non-māori. Hospitalisation rates for Māori were significantly 10 higher than rates for non-māori for each year from 1995/96 to 2007/08. Figure 5: Age-standardised publicly funded hospital discharge rates by ethnicity, 1995/ /08 30,000 Age-standardised rate 25,000 20,000 15,000 10,000 5,000 0 Māori Non-Māori 1995/ / / / / / / / / / / / /08 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. Year 10 Rates were found to be statistically significant using 95 percent confidence intervals. 14 Hospital Events 2007/08

27 Table 8 shows that for both Māori and non-māori, more females were discharged from hospital than males for each year from 1995/96 to 2007/08. Māori males experienced the greatest increase in rates of hospitalisation (48.1%) over the same time period. Table 8: Publicly funded hospital discharges and age-standardised rates by ethnicity and sex, 1995/ /08 Year Māori Non-Māori Male Female Male Female Number Rate Number Rate Number Rate Number Rate 1995/96 36,429 15, ,249 22, ,211 14, ,602 18, /97 38,044 16, ,953 21, ,057 14, ,877 18, /98 41,211 17, ,600 22, ,046 15, ,165 18, /99 44,073 18, ,588 23, ,576 15, ,958 18, /00 47,413 19, ,594 24, ,058 16, ,357 19, /01 52,575 20, ,462 25, ,318 17, ,618 21, /02 55,408 21, ,262 26, ,679 17, ,036 21, /03 58,068 22, ,658 26, ,358 17, ,111 20, /04 60,665 23, ,906 27, ,816 17, ,673 20, /05 63,436 24, ,483 28, ,787 17, ,646 20, /06 66,030 24, ,055 28, ,351 17, ,801 21, /07 67,055 24, ,876 29, ,192 17, ,670 21, /08 65,713 23, ,810 28, ,955 17, ,665 21,767.0 Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. Hospital Events 2007/08 15

28 Figure 6 shows age-specific hospital discharge rates for Māori and non-māori in 2007/08. Hospitalisation rates were higher for Māori compared with non-māori for all age groups except those aged 0 4 years and those aged 85 years and over. Specifically, the hospitalisation rate for Māori was: over twice the rate for non-māori in the year age group more than 1.5 times the rate for non-māori for those in the 15 19, 20 24, 40 44, 45 49, 50 54, and year age groups. Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care. Figure 6: Age-specific publicly funded hospital discharge rates by ethnicity, 2007/08 80,000 70,000 Rate per 100,000 population Māori Non-Māori 60,000 50,000 40,000 30,000 20,000 10, Age group (years) Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. 16 Hospital Events 2007/08

29 Figure 7 shows that hospitalisation rates for Māori males were higher than rates for non- Māori males for all age groups except those aged 0 4 years and those aged 80 years and over in 2007/08. In particular, the hospitalisation rate for Māori males was: over twice the rate for non-māori males in the year age group more than 1.5 times the rate for non-māori males for those in the 25 29, 40 44, 45 49, 50 54, 55 59, and year age groups. Figure 7: Age-specific publicly funded hospital discharge rates by ethnicity, males, 2007/08 100,000 Rate per 100,000 population Māori males Non-Māori males 80,000 60,000 40,000 20, Age group (years) Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. Hospital Events 2007/08 17

30 As shown in Figure 8, hospitalisation rates for Māori females were higher than non- Māori females for those aged 5 29 years and years in 2007/08. Specifically, the hospitalisation rate for Māori females was: over twice the rate for non-māori females in the year age group more than 1.5 times the rate for non-māori females for those in the 15 19, 20 24, 45 49, 50 54, and year age groups. Figure 8: Age-specific publicly funded hospital discharge rates by ethnicity, females, 2007/08 80,000 70,000 Rate per 100,000 population Māori females Non-Māori females 60,000 50,000 40,000 30,000 20,000 10, Age group (years) Note: The rate shown is the age-specific rate per 100,000 of the population in each age group. 18 Hospital Events 2007/08

31 Deprivation Deprivation has been associated with various health outcomes, and it is evident from the social inequalities literature that those who are most deprived generally experience poorer health (Benzeval et al 2001; White et al 2008). See the Definitions section of this document for more information on the New Zealand Index of Deprivation. Therefore, hospitalisation rates are presented in this publication by deprivation quintile according to the New Zealand Deprivation Index 2001 (NZDep2001) (Salmond and Crampton 2002). Figure 9 shows rates of publicly and privately funded hospitalisations by deprivation quintile in 2007/08. It highlights that as deprivation increased, publicly funded hospitalisation rates increased and privately funded hospitalisation rates decreased. In 2007/08, the rate of publicly funded hospitalisations for the most deprived areas was almost twice the rate of the least deprived areas of New Zealand (29,725.5 compared with 15,577.2 hospitalisations per 100,000 population respectively). For privately funded hospitalisations, the rate for the most deprived areas was less than half the rate of the least deprived areas (930.2 compared with privately funded hospitalisations per 100,000 population respectively). Figure 9: Publicly and privately funded hospital discharge rates by deprivation quintile, 2007/08 30,000 25,000 Age-standardised rate Publicly funded hospital discharges Privately funded hospital discharges 20,000 15,000 10,000 5, (least deprived) (most deprived) Deprivation quintile Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population. Hospital Events 2007/08 19

32 Figure 10 shows rates of publicly funded hospital discharges by deprivation quintile and ethnicity. In 2007/08, hospitalisation rates for Māori were significantly 11 higher than those for non-māori at all levels of deprivation. The disparity between Māori and non- Māori hospitalisation rates was greater in the more deprived areas of New Zealand. For both Māori and non-māori, hospitalisation rates for the least deprived areas (quintile 1) were significantly lower than for the most deprived areas (quintile 5) in 2007/08. Figure 10: Publicly funded hospital discharge rates by ethnicity and deprivation quintile, 2007/08 35,000 30,000 Age-standardised rate Māori Non-Māori 25,000 20,000 15,000 10,000 5, (least deprived) (most deprived) Deprivation quintile Note: The rate shown is the age-standardised rate per 100,000 population, standardised to the WHO world standard population; 95 percent confidence intervals. 11 Rates were found to be statistically significant using 95 percent confidence intervals. 20 Hospital Events 2007/08

33 District Health Board region This section presents publicly funded hospital discharge data by DHB region of residence. Note that not all residents in a particular DHB will be treated in that DHB region. Also note that it is not possible to include regional comparisons of privately funded hospitalisations in this publication (see the Data sources, data quality and timing issues section in the Introduction for further information). Table 9 shows that of all DHB regions, Capital & Coast had the highest proportion of hospitalisations for females (59.0%), while Northland had the highest proportion of hospitalisations for males (51.2%) in 2007/08. Northland was the only DHB region in which the number of hospitalisations for males exceeded those for females. Table 9: Publicly funded hospital discharges by DHB region, 2007/08 DHB region Number Rate Percent of discharges Male Female Total Male Female Total Male Female Total Northland 26,739 25,498 52,237 29, , , Waitemata 50,549 62, ,554 18, , , Auckland 37,330 51,366 88,696 17, , , Counties Manukau 46,688 61, ,736 19, , , Waikato 31,841 42,640 74,481 16, , , Lakes 11,846 14,608 26,454 21, , , Bay of Plenty 22,399 27,572 49,971 19, , , Tairawhiti 5, ,588 24, , , Hawke s Bay 14,799 19,543 34,342 17, , , Taranaki 10,311 13,161 23,472 16, , , MidCentral 15,730 19,499 35,229 17, , , Whanganui ,966 21, , , Capital & Coast 17,540 25,207 42,747 12, , , Hutt Valley 13,127 16,897 30,024 17, , , Wairarapa ,611 21, , , Nelson Marlborough 13,500 15,668 29,168 16, , , West Coast , , , Canterbury 42,945 56,427 99,372 16, , , South Canterbury ,812 19, , , Otago 16,755 21,334 38,089 15, , , Southland ,236 22,098 16, , , Overseas and undefined Total New Zealand 412, , ,143 18, , , Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the WHO world standard population. Hospital Events 2007/08 21