Spatial temporal modeling of hospitalizations for fall-related hip fractures in older people.
The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization and sociodemographic data. There was significant spatial temporal variation in hospitalized hip fracture rates in New South Wales, Australia.


BACKGROUND
The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization data.


METHODS
All New South Wales (NSW), Australia residents aged 65+ years who were hospitalized for a fall-related hip fracture between 1 July 1998 and 30 June 2004 were included. Bayesian Poisson regression was used to model rates in local government areas (LGAs), allowing for the incorporation of spatial, temporal, and covariate effects.


RESULTS
Hip fracture rates were significantly decreasing in one LGA, and there were no significant increases in any LGAs. The proportion of the population in residential aged care facilities was significantly associated with the rate of hospitalized hip fractures with a relative risk (RR) of 1.003 (95% credible interval 1.002, 1.004). Socioeconomic status was also related to hospitalized hip fractures with those in the third and fourth quintiles being at decreased risk of hip fracture compared to those in the least disadvantaged (fifth) quintile [RR = 0.837 (0.717, 0.972) and RR = 0.855 (0.743, 0.989) respectively].


CONCLUSIONS
There was significant spatial temporal variation in hospitalized hip fracture rates in NSW, Australia. The use of Bayesian methods was crucial to allow for spatial correlation, covariate effects, and LGA boundary changes.
Turner
R M
RM
NSW Injury Risk Research Management Centre, University of New South Wales, Sydney, NSW, 2052, Australia.
Hayen
A
A
Dunsmuir
W T M
WT
Finch
C F
CF
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001499:Bayes Theorem; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009517:New South Wales / Q000453:epidemiology; D012307:Risk Factors; D013029:Space-Time Clustering