Nikolai Minko District Health Boards NZ www.dhbnz.org.nz (P44, 1/10/09, Sigma Room, 5.02)

1. Inpatient discharges
demographic profiles. What do
they tell us?
Nikolai Minko, Michael Rains and Paul Bridgford
Health Workforce Information Programme
(HWIP)
District Health Boards New Zealand
October 1, 2009

2. Contents
• Patient-centred health care
• Age profiles
• Socio-economic status
• Patients to population ratio
• Conclusions

3. Patient –Centred Health Care
General
Practitioner
Emergency
Department
Outpatient Inpatient

4. Inpatient
• Ten years National
Data Collection
• Largest work load for
medical staff
• Complex Cases

5. National Minimum Data Set
1999-2008
Female Male Total
Events 4 937 572 3 905 042 8 842 745
Patients 1 569 405 1 317 304 2 886 765
Events/Patient 3.15 2.96 3.06

6. Inpatient information
• Encrypted NHI
• Event ID
• Age
• Gender
• Socio-Economic Status
• Ethnicity

7. Inpatient Age profiles…
• Events
• Patients
• Average annual increment in events and
patients number over 10 years

8. Patients Age and Gender
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
0 20 40 60 80 100
AverageAnnualNumber
Age
M_Events F_Events M_Patients F_patients

9. Events to patient ratio
1.20
1.40
1.60
1.80
2.00
2.20
0 20 40 60 80 100
EventstoPatientRatio
Age
M_Events/Patients F_Events/Patients

10. Annual events and patient growth
-150
-100
-50
0
50
100
150
200
250
300
0 20 40 60 80 100
AverageAnnualGrowth
Age
M_Evt F_Evt M_Pat F_Pat

11. Socio-Economic Status…
• How to measure it
• How it affects inpatient events
• How it affects age profiles

12. Measures with New Zealand Deprivation
index (NZDep)
– Ten levels from 1 (lowest) to 10 (highest)
deprivation
– Deciles from domicile rather than population
– Each level has approximately 10% of
population

13. Socio-Economic Status
550000
734000
918000
1102000
1286000
1470000
1654000
1838000
60000
80000
100000
120000
140000
160000
180000
200000
1 3 5 7 9
Populationin3Years
Dischargesin3Years
NZDep
M_Patients F_Patients F_Population M_Population

14. Inpatient Age - Gender profiles by
NZDep quintile
Female Male
0
10
20
30
40
50
60
70
80
90
100
3500 2500 1500 500 500 1500 2500 3500
Age
Discharges in 3 years
M_NZDep_1&2
F_NZDep_1&2
M_NZDep_3&4
F_NZDep_3&4
M_NZDep_5&6
F_NZDep_5&6
M_NZDep_7&8
F_NZDep_7&8
M_NZDep_9&10
F_NZDep_9&10

15. Events to population ratios…
• Inpatient events and population
comparison
• Average events to population ratio by age
groups
• Events to population growth above the
population growth

16. New Zealand Population in 2006
0
5000
10000
15000
20000
25000
30000
35000
0 20 40 60 80 100
Headcount
Age
Female Population Male Population
M_Events F_Events

17. Inpatient events to population ratio
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
DischargesRatio
AgeGroups
Male Female

18. Events to population ratio growth
0%
20%
40%
60%
80%
100%
120%
140%
160%
0%
50%
100%
150%
200%
250%
300%
350%
FemaleDischargesRatio
MaleDischargesRatio
AgeGroups
Male Male/1999 Female Female/1999

19. Conclusions
• Gender and socio-economic status have a
significant impact on inpatient age profile
• While the number of events is steadily
growing with increasing deprivation, but
the growth rate varies with age
• The use of socio-demographic information
can only improve health service
forecasting and planning

20. Limitations
• There is no outpatient-inpatient transition
• Possible effect of the elective throughput
on the age profiles, specialty demand
• Statistics New Zealand population
projection accuracy

21. Questions
Nikolai Minko
Senior Analyst, District Health Boards New
Zealand, Wellington
Telephone: 04 803 5829
Email: nikolai.minko@dhbnz.org.nz
Contact Information