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Injury mortality and morbidity in Ireland Anthony Staines and Mairín Boland for The Injury in Ireland group.

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Presentation on theme: "Injury mortality and morbidity in Ireland Anthony Staines and Mairín Boland for The Injury in Ireland group."— Presentation transcript:

1 Injury mortality and morbidity in Ireland Anthony Staines and Mairín Boland for The Injury in Ireland group.

2 Injury in Ireland Group Anthony Staines (UCD) Patricia Fitzpatrick (UCD) Elaine Scallan (FSAI) Alan Kelly (TCD) Conor Teljeur (TCD/SAHRU) Marie Laffoy (ERHA)

3 Background Major public health problem Most injuries never come to medical notice A minority are fatal Very important cause of acquired long-term disability in children and younger adults

4 Data sources Three data sources Irish census 1981,1986,199,1996 Hipe hospital admissions data Mortality data

5 Geography Not much available! Two geographies Hipe: city and county level only Mortality: city, town, and rural areas as well

6 Area populations (1996) Total 3,626,087 Hipe geography City1,337,271 Other2,288,816 Mortality geography City1,337,271 Urban districts 355,368 Rural areas1,933,448

7 Admissions ( ) Injury admissions by area No area identified 9,889 Not in a city 350,432 In a city 184,035 Total544,356

8 Restrictions (Admissions) Remove 9,889 admissions of people with no fixed abode (537) (0.1%), or normally resident outside Ireland (9352) (1.7%). Remove 59,181 (10.8%) admissions with no E-code, which cannot be classified as to Cause or Intent. Exclude 3,098 (0.6%) admissions of people with E-codes indicating only the location of the injury (E8490-E8499). 472,796 admissions left (86.5%)

9 Admissions by sex Injury admissions by sex Females216,738 Males327,618 Unintentional injury 396,243 admissions (83% of eligible cases) (72% of all cases)

10 Deaths 1981 – 1997 Total 24,912 Unintentional18,185 Males12,026 Females 6,159

11 Areas (Unintentional deaths) Two level geography City6,039 Other12,146 Three level geography City 6,039 Urban 1,954 Rural10,192

12 Principal questions Concentrate on unintentional injury 396,243 admissions 18,185 deaths Rates of unintentional injury by area, age and sex SMRs/SARs comparing cities to the remainder of the country by cause

13 Death rates Males and Females

14 Death rates City and Other

15 Ratios of death rates

16 Death rates City;Urban;Rural

17 Admissions Males and Females

18 Admissions City and Other

19 Ratios of admission rates

20 SMRs and SARs by area

21 SMRs by cause, City and Other

22 SARs by cause, City and Other

23 SARs by selected causes, City, Urban, Rural

24 Limitations Problems of geography Coarse, and may be unreliable Problems of coding External causes often poorly documented in hospital records May be better for mortality, because of coroners Definitions of Injury For our purposes, external cause actually coded Incomplete data Location coding is poor, for example

25 Conclusions Substantial differences between injury experience in major cities, and other parts of the country Observed for deaths and admissions Fairly consistent ordering for all causes by sex and age City < Urban < Rural

26 Cause specific variations Some have obvious explanations Natural Machinery Some not so obvious Firearm deaths higher in country, but admissions higher in city ?Suicide vs. Crime Poisoning ?Agrochemicals

27 Implications Need to target injury prevention measures to different areas as well as different age groups Need to address transport hazards in rural areas Improve geography on HIPE system! More systematic training for coders on injury coding


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