Sport/leisure injury hospitalisation rates--evidence for an excess burden in remote areas

Information about the regional population distribution of sports injury rates is important for the identification of priority groups for injury prevention and sports medicine service delivery. This study describes the relationship between regional measures of social disadvantage (socio-economic index for areas, SEIFA) and remoteness (accessibility/remoteness index of Australia, ARIA) and the incidence of sport/leisure hospitalisation episodes for 2003-2004. All hospital separations, of New South Wales (NSW, Australia) residents, with an ICD-10-AM principal diagnosis indicating an injury and an activity code indicating sport/leisure activity were included. Age-standardised hospitalisation rates were calculated across SEIFA and ARIA categories. There was no clear trend in hospitalisation rates across SEIFA quintiles, with rates ranging from a low of 150.3/100,000 population (95% CI: 145.5-155.2) in the quintile of most disadvantage to a high of 201.8/100,000 population (196.1-207.4) in the middle quintile. In contrast, there was a strong positive and significant trend across ARIA groups (p<0.001) with rates ranging from a low of 156.2/100,000 population (153.2-159.2) in the most urban areas to a high of 335.5/100,000 population (306.5-364.6) in remote areas. Reasons for these trends are unclear but may include differences in medical and allied health service provision, sport/leisure infrastructure and opportunities across regions or differential participation in sport across NSW. Further investigations into why remote and very remote areas, in particular, have such high rates, including exploration of participation rates, sport/leisure opportunity delivery factors and the provision of sports medicine services need to be undertaken before injury rates can be reduced in these areas.