Emergency admissions of older people to hospital: a link with material deprivation

Lucy K Smith

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Health disparities and outcomes Emergency and Acute Care Studies Public Health and Social Inequalities

Abstract

BACKGROUND: The aim was to investigate whether variations in emergency admission to hospital amongst older people in Leicestershire vary with the level of material deprivation of the area in which they live. METHODS: Data were extracted from the Trent Patient Information System for patients aged 65 and over, admitted as an emergency medical admission to Leicestershire's acute and community hospitals on at least one occasion during the period October 1993-September 1994. The 1991 Census was used to examine the nature of the areas from which these emergency admissions were drawn and variations in emergency admission rates across Leicestershire. The relationship between emergency medical admissions and age, sex and material deprivation as measured by the Townsend deprivation score was examined. RESULTS: There were 13,305 people aged 65 or over with at least one emergency medical admission out of an estimated population (65 and over) in 1994 of 134,608 (9.9 per cent). Unconditional logistic regression showed that the risk of emergency admission increased with age and was also higher for men than for women. Emergency admissions increased significantly with increasing deprivation for each age group. This was most notable in the 65-74 years age group, yielding an odds ratio of 2.06 [95 per cent confidence interval (1.86, 2.29)], when comparing those from the most deprived areas with those from the least deprived areas. CONCLUSIONS: The increased risk of emergency medical admission to hospital, which is associated with residence in areas characterized as deprived by Census-based indicators, suggests there are enduring inequalities in health or health care amongst older people. Inequalities noted for all ages persist into old age, although in the 'oldest' age groups, the effect is weaker. Material deprivation may also be a proxy for other factors, such as differences in social support and the type of care received.

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References

1983Inequalities in Health, The Black Report 1987Health and Deprivation: Inequality and the North 1997Lifetime socioeconomic position and mortality: prospective observational study 1994Higher mortality in deprived areas: community or personal disadvantage?1994Widening inequality of health in northern England, 1981-91 1990Inequalities in health: ten years and little further on 1993Ageing and economic welfare 1994Are multidimensional social classifications of areas useful in UK health service research?

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