Persons with disability, social deprivation and an emergency medical admission

Ir J Med Sci. 2018 Aug;187(3):593-600. doi: 10.1007/s11845-018-1736-y. Epub 2018 Jan 16.

Abstract

Background: The community level of disability and social deprivation may result in an emergency hospitalisation; we have examined the annual admission incidence rate for emergency medical conditions in relation to the community prevalence of such factors.

Methods: All emergency medical admissions (96,305 episodes in 50,612 patients) within the institution's catchment area were examined between 2002 and 2016. The frequency of disability, level of full-time carers and unemployment for the 74 electoral divisions of the catchment area was regressed against admission rates; incidence rate ratios (IRR) were calculated using truncated Poisson regression.

Results: Disability was present in 12.1% of the catchment area population (95% CI = 9.7-15.0). The annual admission incidence rates/1000 population across disability quintiles for the more affluent areas increased from Q1 7.6 (95% CI = 7.4-7.8) to Q5 27.3 (95% CI = 27.0-27.5) and for the more deprived area from Q1 16.6 (95% CI = 16.4, 16.8) to and Q5 40.4 (95% CI = 40.1-40.7). Disability status influenced the overall admission IRR (compared with Q1/Q3) for Q4/Q5 1.11 (95% CI = 1.09-1.13) showing an increased rate of hospitalisation for the more deprived areas. Community disability levels interacted with local area unemployment and frequency of full-time carers; as they increased, a linear relationship between disability and the admission rate incidence was demonstrated.

Conclusion: Local catchment area disability prevalence rates in addition to social deprivation factors are an important determinant of the annual incidence rate of emergency medical admissions.

Keywords: Deprivation; Disability; Emergency medical admissions.

MeSH terms

  • Aged
  • Disabled Persons / psychology*
  • Emergency Medical Services / methods*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Patient Admission / standards*