Deprivation status and the hospital costs of an emergency medical admission.

Abstract

BACKGROUND: Deprivation has been shown to adversely affect health outcomes. However, whether deprivation increases hospitalisation costs is uncertain. We have examined the relationship between deprivation and the costs of emergency medical admissions in a single centre between 2008-2014. METHODS: We calculated the total hospital costs of emergency admissions related to their deprivation status, based on area of residence (Electoral Division - small census area). We used truncated Poisson and quantile regression methods to examine relationships between predictor variables and total hospital episode costs. RESULTS: Over the study period, 29,508 episodes were recorded in 15,932 patients. Compared with the least deprived (Q1), the incidence rate ratios (IRR) for annual costs were increased to Q3 1.15 (95% CI: 1.12, 1.19), Q4 2.39 (95% CI: 2.30, 2.49) and Q5 2.76 (95% CI: 2.68, 2.85). The margin statistic cost estimate per thousand population increased from 183.8 K€ in Q1 to 507.9 K€ in Q5. The total bed days/1000 population increased as follows (compared with Q1): Q3 IRR 1.41 (95% CI: 1.37, 1.45), Q4 1.96 (95% CI: 1.89, 2.03) and Q5 3.04 (95% CI: 2.96, 3.12). The margin statistic bed day estimate (/1000 population) increased from 218.7 in Q1 to 664.0 in Q5. CONCLUSION: Deprivation status had a profound impact on total hospital costs for emergency medical admissions. This was primarily mediated through a tripling of total bed days in the most deprived groups.