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Hospitalisation of children under 15 years in Victoria
P D Phelan1, J Bishop, K Baxter
1University of Melbourne.
Insights
Children in rural Victoria had a 50% higher hospital separation rate than urban children. This disparity, particularly for respiratory conditions like asthma and otitis media, suggests variations in medical practice may be the cause.
Area of Science:
- Pediatric healthcare utilization
- Rural health disparities
- Hospital discharge analysis
Background:
- Understanding geographic variations in healthcare access and outcomes is crucial for public health.
- Previous studies have indicated potential differences in healthcare utilization between rural and metropolitan populations.
Purpose of the Study:
- To compare hospital separation rates for children (0-15 years) in rural versus metropolitan Victoria.
- To explore potential explanations for any observed differences in separation rates.
Main Methods:
- Analysis of public hospital discharge data for children aged 0-15 years in Victoria (1988-1991).
- Discharge rates were calculated based on local authority area of residence.
- Patients were categorized using Diagnosis Related Groups (DRGs) version 5.
Main Results:
- Children residing in rural Victoria exhibited a 50% greater hospital separation rate compared to their metropolitan counterparts.
- Separation rates remained consistent across the three financial years studied.
- Specific conditions, including asthma, bronchitis, otitis media, and upper respiratory infections (URI), showed significantly higher separation rates in rural areas.
Conclusions:
- The study suggests that variations in medical practice are the most probable explanation for the observed higher hospital separation rates among rural children.
- Further investigation into practice patterns and access to care in rural settings is warranted.
Objective:
To determine whether the separation rate from the hospital for children aged 0-15 years in Victoria was higher for those resident in the country area of the State in comparison with the metropolitan area and, if it was, to investigate possible explanations.
Design:
Discharge data from all public hospitals in Victoria for children aged 0-15 years for the financial years 1988-89, 1989-90 and 1990-91 were analysed with detailed analysis being done on the 1990-91 data set. Discharge rates were determined according to the local authority area of residence. Patients were grouped according to Diagnosis Related Groups (DRGs) version 5.
Results:
Children living in the country area showed a separation rate of 50 per cent greater than that for the metropolitan area. Separation rates for local authority areas were remarkably constant over the three years. Country local authority areas with the highest separation rates had separation rates for asthma and bronchitis (DRG 98), almost four times that of metropolitan residents, and for otitis media and upper respiratory infection (URI), a rate almost ten times that of metropolitan residents.
Conclusion:
It is suggested that variation in medical practice was the most likely explanation for the observed differences.