M
II
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Y
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U
AUSTRALIA
PRIVATE HOSPITAL INJURY ADMISSIONS VICTORIA,
JANUARY 1993-JUNE 1994 :
A COMPARISON WITH PUBLIC HOSPITALS
Project funded by
Department of Health and Community Services, Victoria
and
Victorian Health Promotion Foundation
•
ACCIDENT
~
VicHealth
RESEARCH
CENTRE
PRIVATE HOSPITAL INJURY ADMISSIONS VICTORIA,
JANUARY 1993-JUNE 1994 :
A COMPARISON WITH PUBLIC HOSPITALS
by
Graeme M Watt
May 1995
Report No 71
This project was undertaken by Graeme Watt of the Department of Health and Community
Services (Victoria) while on time-release from the Department.
MONASH UNIVERSITY ACCIDENT RESEARCH CENTRE
REPORT DOCUMENT PAGE
Report No
71
Report Date
ISBN
May 1995
073260071 5
Pages
70
Title and sub-title:
PRIVATE HOSPITAL INJURY ADMISSIONS VICTORIA, JANUARY 1993 - JUNE 1994: A
COMPARISON WITH PUBLIC HOSPITALS.
Author
Type of Report and Period Covered
Watt, GM
Sponsoring
General, January 1993 - June 1994
Organisations:
Department of Health and Community Services (Victoria)
Abstract:
Data relating to injury admissions to Victorian private hospitals for the eighteen months
January 1993 to June 1994 were analysed to determine frequencies and injury causes,
and these results compared to similar data for public hospitals for the six years July 1987 to
June 1993.
It was found that the Victorian Inpatient Minimum Dataset was recording a rapidly
increasing number of hospitalised injury admissions over the three years 1991/1992 to
1993/1994. The quality of data relating to private hospital admissions was poor and
inconsistent for the two years studied.
About 20% of all injury admissions in VIMD were to private hospitals. This was a higher
than expected number and suggests that these injuries should be taken into account for
statistical purposes. The most frequent causes of injury presenting to private hospitals
were, in order, medical, falls, hit/struck/crush and transport injuries.
When compared with public hospital data, private hospitals appear to admit more persons,
relatively, over 25 years of age than public hospitals, but far fewer children and young
people.
The general lack of emergency department facilities at private hospitals and issues relating
to private health insurance probably accounts for the relatively low admission frequency of
intentional injury cases, and also of transport injuries. On the other hand, sporting injuries
were relatively more common in private than public hospitals, possibly because of the
existence of private specialist sports injury facilities.
KeyWords:
epidemiology; injury; overview; private
hospitals; public hospitals; morbidity; all
ages; unintentional injury; intentional
injury
Reproduction of this page is authorised.
Disclaimer:
This report is disseminated in the interests of
information exchange. The views expressed
are those of the author, and not necessarily
those of Monash University nor of the
Department of Health and Community
Services.
Monash University Accident Research Centre
Wellington Road, Clayton, Victoria, 3168
Australia
Contents
Tables
Figures
Acknowledgments
Executive Summary
Recommendations
1.
Aims
Objectives
Background
1
1
1
Data source: Victorian Inpatient Minimum Dataset
Cleaning the data
Method
Biases and limitations
3
3
3
4
Results: Private Hospitals: Frequency, malelfemale distribution
3.1
3.2
3.3
3.4
3.5
4.
(ix)
Research Design
2.1
2.2
2.3
2.4
3.
(v)
(vii)
Introduction
1.1
1.2
1.3
2.
(iii)
(iv)
Frequency by major causes of injury:
eighteen months, January 1993 to June 1994
Frequency by 5-year age group and sex:
eighteen months, January 1993 to June 1994
Bed days by selected major causes of injury:
eighteen months, January 1993 to June 1994
Frequency by major causes of injury :
six months July 1993 to December 1993 compared with
twelve months, July 1993 to June 1994
Frequency by 5-year age group and sex:
six months July 1993 to December 1993 compared with
twelve months, July 1993 to June 1994
5
9
10
11
13
Results: Private Hospitals compared with Public Hospitals
4.1
4.2
4.3
4.4
Comparison of 6 months private hospital data with 12 months private
hospital data and 12 months public hospital data
15
Age group and sex distribution comparison
15
Bed days comparison
17
Comparisons by major injury groups
19
4.4.1
True, non-true
19
4.4.2
Non-true
19
(i)
4.4.3
4.4.4
4.4.5
4.4.6
4.4.7
5.
20
20
21
22
22
Discussion
5.1
5.2
5.3
6.
Intent
Intentional.
Unintentional
Transport
Sport
Method
Frequency, major causes, age and male/female distribution
Comparisons with public hospital data
References
23
24
25
27
Appendices
Appendix 1: ICD-9-CM E-codes used for disaggregation of injury causes
Appendix 2: Examples of injury types for injury categories
Appendix 3: Private Hospital Admissions
Private Hospital Admissions
compared with Public Hospital Admissions
(ii)
PI,· I
i,1I
I. I
29
33
37
66
Tables
Table
Table
Table
Table
Table
1:
2:
3:
4:
5:
Frequency,
Frequency,
Frequency,
Comparison
Comparison
injury
total (males and females)
males
females
of private and public hospital admissions by financial year
of private and public hospital admissions by unintentional
6
7
8
15
21
Appendix 1: ICD-9-CM E-codes used for disaggregation of injury causes
29
Appendix 2: Examples of injury types for injury categories
33
Appendix 3:
Private Hospital Admissions
Table
Table
Table
Table
Table
Table
Table
Table
Table
Table
A:
B:
C:
0:
E:
F:
G:
H:
I:
J:
Six months, Jan 1993 - Jun 1993, Total (males and females)
Six months, Jan 1993 - Jun 1993, Males
Six months, Jan 1993 - Jun 1993, Females
Twelve months, Jul1993 - Jun 1994, Total (males and females)
Twelve months, Jul1993 - Jun 1994, Males
Twelve months, Jul1993 - Jun 1994, Females
Eighteen months, Jan 1993 - Jun 1994, Total (males and females)
Eighteen months, Jan 1993 - Jun 1994, Males
Eighteen months, Jan 1993 - Jun 1994, Females
Male:Female ratio, six months compared with twelve months
38
41
44
47
50
53
56
59
62
65
Private Hospital Admissions compared with Public Hospital Admissions
Table K:
Table L:
By age group
By injury group
66
67
(iii)
Figures
Private Hospital Admissions, Eighteen monttis, Jan 1993 - Jun 1994
Figure 1:
Figure 2:
Figure 3:
Figure 4:
Figure 5:
Total (males and females)
Major causes of unintentional injury
Transport injuries
By five-year age group
Male/female distribution
5
5
9
9
10
Private Hospital Admissions, Bed days, Eighteen months
Figure 6:
Figure 7:
Figure 8:
All injuries
True injuries
Non-true injuries
10
11
11
Private Hospital Admissions, Six months compared with Twelve months
Figure
Figure
Figure
Figure
Figure
9:
10:
11:
12:
13:
Total (males and females)
Major causes of unintentional injury
Transport injuries
By five-year age group
Male/female distribution
12
12
12
13
13
Private Hospital Admissions, Eighteen months, Jan 1993 - Jun 1994
compared with Public Hospital Admissions, average annual total,
Jul1987 - Jun 1993.
Five-year age groups
Figure 14:
Figure 15:
Figure 16:
Total (males and females)
Males
Females
16
16
16
Bed days
Figure 17:
Figure 18:
Figure 19:
Figure 20:
All injuries
Motor vehicle traffic injuries
Falls
Non-true injuries
17
17
18
18
Major injury groups
Figure 21:
Figure 22:
Figure 23:
Figure 24:
Figure 25:
Figure 26:
Figure 27:
True/non-true
Medical injures and late effects
By intent.
Intentional
Unintentional
Transport
Sport
,
(iv)
19
19
20
20
21
22
22
Acknowledgments
This report would not have been possible without the data obtained from the Victorian
Department of Health & Community Services. The use of that data is gratefully
acknowledged.
The Department of Health & Community Services also played an
important part in the production of this document by allowing time-release for the author to
conduct the project at Monash University Accident Research Centre (MUARC). In both
ways, the Department can be seen to be taking an active part in the prevention of injury in
this state.
I would like to express my gratitude to Dr Joan Ozanne-Smith and Professor Peter Vulcan
at MUARC for their agreement and encouragement to obtain time-release, and for the
unending helpful advice and suggestions.
To Ms Giulietta Valuri and Ms Christina Leong I again extend my thanks for their tolerance
and invaluable assistance. As Julie's and Christina's assistance with this project is
supported by Vic Health, that organisation is also acknowledged.
(v)
Executive Summary
This report represents the adoption of a recommendation from an earlier MUARC report1
which described the epidemiology of injury in Victorian public hospitals, viz,
A formal study should be undertaken to determine the effect of admissions to private
hospitals arising from injury with respect to epidemiology and injury prevention.
Hence this document describes the all-age epidemiology of injuries for which there are
data, treated in Victorian private hospitals by frequency for the eighteen months period
January 1993 to June 1994 A comparison is made between these injuries and those
admitted to Victorian public hospitals.
As for previous reports, the Victorian Inpatient Minimum Dataset (VIMD) was analysed; in
this study only for the eighteen month period mentioned above. Even though only data
from 60% of private hospitals for the six months January to June 1993, and from 95% for
the twelve months July 1993 to June 1994 are included, the underlying purpose of the
study was to determine the effect of the inclusion of these private hospital data in VIMD
when used as a source of statistics on Victorian injury. To date, it has been assumed for
calculations for rates that all hospitalised injury presents to public hospitals.
The Victorian
There was
1992/1993
1992/1993
insufficient
increasing
suggestion
Inpatient
Minimum
Dataset
an increase of about 18% in injury admissions to public hospitals from
to 1993/1994. This compares with an increase of 11% between 1991/1992 and
and an average increase of about 2% for the previous six years. There are
data to make a similar comparison for private hospital admissions. This rapidly
rate of admission is possibly due to the introduction of case-mix funding, but this
needs to be formally investigated.
The quality of the data being provided by the private hospitals to VIMD appears to be
inconsistent. The high numbers of injuries found to be classified as "other" may reflect
poor coding practices by some private hospitals. Even within major injury groups, it was
disappointing for research purposes at least, to find so little disaggregation of injury.
A further feature of concern is the variability between the private hospital data for 1992/
1993 and 1993/1994 where in the latter year, there seems to have been even less
disaggregation of major injury groups than in 1992/1993.
Frequency,
major
causes,
age and male/female
distribution.
There was a total of 114,909 recorded injury admissions to Victorian hospitals in
1993/1994,22,864
(19.9%) to reporting private hospitals. For the previous 12 months,
18.5% of injury cases in VIMD were recorded as having been admitted to the reporting
private hospitals. This represents in excess of 20,000 cases per annum based on the 18
months data available. That there is such a high number of injuries presenting to private
hospitals is of interest.
Approximately 4% of admissions to private hospitals were transfers from public hospitals.
As well, 4% of separations from private hospitals were transfers to public hospitals. As
(vii)
these transfers were not excluded from either the private or public hospital data, the results
will be biased to the extent of this double counting.
About 60% of the private hospital injury admissions were found to be true injuries, and
almost all of these were unintentional, with falls, hit/struck/crush and transport injuries
comprising the most frequent major injury groups in order of frequency. Admissions due to
intentional injury, both self-inflicted and assault, were not high. Medical injuries (non-true
injuries), were of higher frequency than any category of true injuries.
The age and male/female distributions of injury admissions to private hospitals were similar
to those for public hospitals.
The analysis of private hospital injury admissions does not change the emphasis currently
being placed on injury prevention activity.
Comparisons with public hospital data
Generally, this study has shown that the data in VIMD relating to private hospitals are not
very much different from that for public hospitals, but research investigations of certain
injury groups will need to take into account that there are some differences.
Private hospitals appear to admit relatively fewer young persons, of either sex, up to the
age group 20-24 years. Hence it would be reasonable to ignore the cases of private
hospital child and adolescent injury in VIMD for calculation of rates and trends for these
age groups. On the other hand, from 20-24 years, private hospitals admit a higher
proportion of patients presenting with injury than do public hospitals. These cases should
not be ignored in the calculation of rates of injury.
The proportion of injury cases classified as late effects of injury and medical injuries was
higher for private hospitals than public hospitals. The circumstances of medical injuries in
both public and private hospitals needs to be investigated formally. It is speculated that the
majority of cases are the result of procedures being carried out on elderly patients following
the primary cause of hospitalisation, which was probably not an injury.
The general lack of emergency department facilities at private hospitals is a possible
explanation for the low admission frequency of intentional injury cases. Intentional injury
constituted only 0.9% of private hospital injury admissions, compared to 7.5% of public
hospital injury admissions. Other possible reasons for the low intentional injury numbers
include the lack of private insurance, non-disclosure of intent, and lack of protocols for
identifying cases of intentional injury cases.
Unfortunately, the interpretation of the results of the analysis of unintentional injury cause
has been made imprecise because of the high number of cases coded as "other".
Generally, it appears transport injuries present less frequently at private hospitals, again,
probably due to the lack of emergency department facilities, but sporting injuries are not
uncommonly seen at private hospitals. As there are known to be private specialist sports
injury treatment hospitals, this finding is able to be accounted for.
For all injuries, hospital bed use patterns for private hospitals were similar to public
hospitals. There may be a tendency for patients to stay for shorter periods in private
hospitals.
(viii)
idHI
1,11
III
Recommendations
1.
The Department of Health & Community Services should continue to monitor the
quality of the data being included in the Victorian Inpatient Minimum Dataset,
particularly the data derived from private hospitals, and steps should be taken to
improve the data quality. The results of their monitoring should be made readily
available to researchers.
2.
Poor quality data collections should be referred back to the hospitals of origin as part
of a routine quality control process.
3.
A formal study should be undertaken urgently to determine the effect of case-mix
funding on admission policy of public and private hospitals and how this might affect
any analysis of the Victorian Inpatient Minimum Dataset for injury prevention and
evaluation purposes.
4.
To obtain true Victorian injury rates, the total data in the VIMD should be used. To
obtain trends in rates, it may be necessary to restrict data analysis to public hospital
admissions for the next few years until the bias due to the inclusion of private hospital
data is no longer important.
5.
The Department of Health and Community Services should consider making available
to MUARC private hospital identifiers for agreed research purposes.
6.
As private hospitals tend to admit older (than 20-24 years) patients for injury more
frequently than public hospitals, calculation of rates should take into account private
hospital data for older age groups.
7.
A formal detailed descriptive epidemiological study should be undertaken to
determine the reasons for the high numbers of medical injuries appearing in public
and private hospital data. This may lead to a proper justification for the exclusion of
these injuries from further injury prevention research and provide useful information
for the evaluation of medical procedures and hospital quality control programs
8.
Sports injury studies should take into consideration the admission of sports-injured
patients to private hospitals.
(ix)
1.
Introduction
1.1
Aim
To describe the all-age epidemiology of hospitalised injuries in Victorian private hospitals
by frequencies and type of injury for the period January 1993 to June 1994, and to
compare it with hospitalised injuries in Victorian public hospitals for the six year period July
1987 to June 1993.
1.2
Objectives
1.2.1
To analyse the data in the Victorian Inpatient Minimum Dataset (VIMD)
relating to all-age injury hospital separations in Victorian private hospitals for
the 18-month period, January 1993 to June 1994, and describe their
frequency by external causes, 5-year age groups «1. 1-4, 5-9 ... 75-84. >85
years) and sex.
1.2.2
1.3
To compare these data with public hospital data for the 6-year period July
1987 to June 1993.
Background
In January 1995, an updated determination of the all-age all-injury epidemiology of
admissions to Victorian public hospitals for the six-year period July 1987 to June 1993 was
published.1 This was based on the data contained in the Victorian Inpatient Minimum
Dataset (VIMD). Included in the data for the financial year July 1992 - June 1993, there
were 17,693 cases of injury admitted to private hospitals, 18.5% of the total cases in
1992/1993. As this was the first year private hospital data had been included in VIMD, it is
desirable to determine if the injuries presenting to these hospitals are significant in terms of
the epidemiology of hospitalised injury for the state .
.. 1 ..
.. 2 ..
2.
Research Design
The research design is similar to that contained in Watt1 and has been summarised here.
2.1
Data source: Victorian Inpatient Minimum Dataset
Victorian public hospital morbidity data have been collected in a reasonably consistent form
since about 1985 by the Department of Health & Community Services (Victoria) into·the
Victorian Inpatient Minimum Dataset (VIMD). The primary purpose of the data collection is
for health policy and planning in the Department of Health & Community Services.
VIMD consists of data on all separations from Victorian public hospitals, and from 1 July
1992, about 60% of Victorian private hospitals also contributed data with 95% of private
hospitals contributing in 1993/1994. Further private hospital data will be available in future
years. The Victorian Department of Health & Community Services has the overall
responsibility for collecting the data, but it is actually handled and stored by Health
Computing Services Victoria (HCS).
Monash University Accident Research Centre (MUARC) has been authorised to purchase
data with confidential information excluded, relating to injuries during the seven financial
years 1986/1987 to 1992/1993 to use for research purposes. The variables in the subset
of the VIMD supplied include, as well as a primary E-code in accordance with the
internationally used ICD-9-CM manual,2 an encrypted admission number (UR number),
sex, date of birth, data of admission, date of separation, a principal diagnosis (N-code) and
up to four further diagnosis codes, postcode of residence, and a separation code
(discharge destination).
2.2
Cleaning the data
Cases of re-admissions to the same hospital by the same patient for the same external
cause of injury were removed by MUARC staff.
Transferred patients were not excluded. For the 18-month period January 1993 to July
1994, 4.0% of patients admitted to private hospitals coded with an E-code were transferred
from public hospitals, and 4.3% were transferred out to public hospitals.
Although VIMD records a date of admission for each case, the injury cases selected are
separations from the hospitals. After cleaning of the data, the separations are equivalent
to admissions. Hence for the purposes of this study cases will be referred to as
"admissions" .
2.3
Method
Categories of injury cause were based on E-code groupings as used in other Monash
University Accident Research Centre studies. See Appendices 1 and 2 for definitions and
descriptions of these groups .
.. 3 ..
Using 1992/1993 data extracted from V/MD using an SPSS-X program,3 particular data
were transferred manually to Excel,4 in which manipulations of the data were performed.
The data for all-age separations for the 6-month period, January 1993 to June 1993 were
analysed by external causes and frequency by age-specific groups. Injuries were
categorised as "true" and "non-true" as in previous MUARC reports. eg 1
2.4
Biases and limitations
Cases with a postcode of residence that was not Victorian were not excluded from the data
as they were treated in Victorian private hospitals. Victorians injured but treated outside
the state were not included in the data as they could not be identified. The possible bias
introduced by these factors is considered to be insignificant.
The non-exclusion of transferred patients represents a source of bias because of double
counting of cases. This may be less significant for private hospital than public hospital data
analysis as the proportions and numbers are lower.
.. 4 ..
3.
Results: Private Hospitals
3.1 Frequency by major causes of injury:
Eighteen months, January 1993 to June 1994.
Tables 1 to 3 show the frequency of injury for the major causes for the 18 months total data
available, males, females and total (males and females combined). Fuller versions of
these tables, showing disaggregations of most of the injury groups, are included in
Appendix 3 as Tables G, H and I.
True injuries, including intentional and unintentional, represented 60.7% (24608) and nontrue (medical injuries and late effects) represented 39.3% of the total of all injury
admissions to private hospitals for the 18 months. These results are shown in Figure 1.
Unintentional injuries comprised 98.2% of the true injuries.
Figure 1: Total males and females, % of all injuries
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
40539
All injuries
All non-true injuries
24608 (60.7%)
All true Injuries
Undetermined intent
Intentional
24159 (59.6%)
Unintentional
o
5000
10000 15000 20000 25000 30000 35000
40000
45000
Number
Figure 2: Major causes of unintentional injury
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
Other
Cutting/piercing
Machinery
Hit/struck/crush
Choking
Nat'l/environment
Falls
Fire/burns/scalds
Poisoning
Near-drowning
Transport
o
1000
2000
3000
4000
5000
Number
..5 ..
6000
7000
8000
9000
11515
6
9
3
25
25
194
29
132
32
11
13
16106
138
14
10
12
13
37
378
2
4
10
1
64
3
20
13
0
423
21
878
53
5
11
75
70
881
10
0
350
238
6
56
15
19
272
243
11
17
1
55
0
3
5
8
0
9
5
9
824
47
18
11
134
25
26
34
8
2
3
9
33
16
2
7
4
6
13274
63
168
12904
119
209
0
498
56
4
83
82
22
41
634
409
304
863
666
796
124
40
4
1
387
14
43
24
893
680
59
16
761
73
18
5
779
136
0
6
25
8
72
58Hit/struck/crush
934 2387
27
495
105
123
12
115
114
1-4
8
52
395
149
406
180
23
291
1656
150
15
7
442
67
50
49
128
42
1012
48
120
32
20
129
888
338
289
155
174
102
107
37
927
29
557
13
89
70
0
1062
1207
1617
1300
8669
<1
024
1879
0015
8
3
924
103
130
62
51
31
46
76
1
117
42
216
497
355
139
6
76
126
681
5
2
330
50
15931
81
938
148
37
697
38
563
3326
278
298
753
891
29
28
711
244
114
961
975
47
555
30
700
354
82
539
167
38
7
246
962
942
182
223
26
1
8540
99
2032
1040
1058
1025
1225
2640
1319
1305
1218
2300
1664
1885
1128
1897
1690
1172252750
1686
1349
1418
4
0
797 2661
1447
1731 2472
1343
1728 2561
1050
1374
931
216
931
25
1979
2584
2262
24159
1857
1619
2
1393
1305
1033
1
82
2449
13482
525
853
256
73
24608
15
0
82750-5455-5960-6465-69
5-9
10-1415-1920-2425-2930-3435-3940-4445-49
70-74
549
40
763
1019
3000
2178 2103 2309 2624
2670175-79
259980-84
2132 >=85
2448All40539
TABLE
Eighteen
months,
January
1993Females)
to 30 June 1994
ivateHospital
InjuryAdmissions,
Victoria
Total 1(Males
and
ivate
49
104
12
3
1
60
6
113
40
71
138
26
639
0
42
5644
3
539
555
380
60
69
44
533
447
26
566
83
704
42
24
334
3
93
33
10
148
11
10
14
2
6
114
17
10
13
106
3
2
1
292
178
106
133
5
6
4
0
9
2
23
290
22
84
90
1
63
17
314
311
30
16
113
115
6
7
4
0
185
5
9
2
131
16
1
13
4
3
3336
45
1
35
9
220
87
1406
36
194
373
485
150
505
973
199
26
605
70
12
536Hit/struck/crush
4
9
105
7
8
0
2
1
2437
22
20
1-4
644
59
162
287
25
21
781
257
102
98
0
95
49
<1
21
19
107
102
31
14
115
108
6
620
29
266
13675
559
8
16
215
941
30
391
64
20
165
39
104
14
28
127
34
27
605
157
248
73
613
859
174
277
390
158
121
5
841
184
355
518
349
535
513
178
37
629
285
279
23
304
297
882
0
75
8
9
5
90
8
1476
1968
10
1739
12 025-29
01772
1363
1121
935
02
0
31 126940-44
195
11
35
163
45
113
334
409
800
634
894
7617
13 30-3435-39
27
5-9
524
52
7
32
25
225
19
10-14
15-19
70-74 75-79
294
615
13875
214
65
221
12
328
947
4
247
326
29
245
167
111
13
6211
4
1441
1938 20-24
1720
1346
13
1101
920
13
377
46
446
754
344
442
330
436
655
506
596
1671
21492
2345
2112
1498
26
136445-49
109850-54
112355-59
124660-64
132865-69
1198
TABLE
2
919
HospitalEighteen
Injury
Males
months, 1 January
1993
Admissions,
Victoria
to 30 June 1994
80-84
>=85 All
Self-inflicted
13
665
8
5
134
114
6
1
55
36
190
13
23
80
10
115
107
6
129
239
7
4
426
884
110
176
703
5
2
7
118
95
61
1340
5333
5
23
118
19
20
145
8
41
133
8
8
82
89
125
12
116
103
105
0
1
538
1
436
626
0
511
464
542
3
13
0
6
27
4
4
11
101
33
9
65
18
42
31
38
19
25
27
28
2
18
32
19
17
39
35
1
36
13
7
9
9
20
46
214
14
265
23
3
71
2
0
259
37
17
22
14
237
3
21
33
9
26
205
117
241
138
219
233
16
151
15
230
11
16
15
4
1
6
2
020-24
290
672
19
104
5
133
106
108
16
15
165
109
100
0
201
1-4
316
646
532
473
410
428
933
518
2Hit/struck/crush
1055
1553
<1
138
18
45
4
28
29
46
24
59
89
53
453
23
2
7
15
012
0025-29
127
2
11
186
130
129
2896
11
92
203
318
556
512
445
413
940
638
437
484
534
561
1058
1557
10733
160
110
27
46
34
1043
37
385
257
691
758
44
717
147
358
453
618
558
565
523
567
478
740
20
720
643
53
115
607
598
444
713
571
235
340
327
8314
72
92
21080
1 35-39
10484
02
41
483
834
808
7271
929
888
5-9
10-14
15-19
30-34
219
716
364
327
978
1163
1203
1197
98012
14
1063
129640-44
147245-49
168050-54
153655-59
194260-6465-69
19047
Inflicted by other
Females
ghteen
months, 1 January
1993 to 30 June 1994
Injury Admissions,
Victoria
70-7475-79
Total
80-84
>=85
TABLE
3
Of the unintentional injuries, the major frequencies occurred for falls, hit/struck/crush,
transport and cutting/piercing groups. Only 3.4% of the falls were classified as falls in
sport, but 37.4% of the hit/struck/crush injuries were collisions in sport. The "other"
category was very high. See Figure 2.
Motor vehicle traffic injuries were 61 % of all transport injuries, following by non-motor
vehicle traffic injuries (31.1 %) and motor vehicle non-traffic. This is shown in Figure 3. Of
non-motor vehicle traffic injuries where the cause was identified, 31.5% were animals being
ridden, and another 31.5% were pedal cyclists.
Figure 3: Transport injuries, number and % of all transport injuries
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
Motor vehicle traffic
1012(61.1
Motor vehicle
non-traffic
Non-motor
vehicle traffic
o
200
400
600
800
1000
1200
Number
3.2 Frequency by 5-year age group and sex:
Eighteen months, January 1993 to June 1994.
By 5-year age group, the highest frequency of injury admissions occurred for the 20-24 ,
25-29 and 30-35 year-olds. The admissions of those 65 years and over were also high.
Males outnumbered females in all 5-year age groups to 65-69 years, whereafter females
were predominant. See Figures 4 and 5.
Figure 4: Distribution
by 5-year age group
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994 .
..8
3500
~E 1500
2500
500
3000
01000
2000
~
~
r-,
6JN
'<t
co
eo
'<t
''<t
M
<t
Cl
ID
...:.
1\
..n
n
11
s)
..
9 ..
Figure 5: Malelfemale distribution
by 5-year age group
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
II
1.1
1.1
1000
Z::lE 2500
I
[]
11
lIB Females
Males
1""':":"1
~
N
(l)
(.~
U'l
O'l
500 "'"
6.n('),.....nU'l"'""'"An')
CIO
11
~
0
3.3 Bed days by selected major causes of injury:
Eighteen months, January 1993 to June 1994.
Figures 6, 7 and 8 show the number ,expressed as a percentage, of hospital bed days
used by patients admitted for all injuries, non-true injuries (medical injuries and late
effects), and true injuries.
For all injuries, 49% (19858 of 40539) of patients were in hospital for one or two days only,
37% for three to 14 days, and 14% for 15 days or more. Comparing the two major groups
of injury, the percentage of patients with true injuries remaining one or two days is 61% but
for non-true injuries this is only 31 %. Thirty percent of patients admitted with true injuries
stay for three to 14 days, compared with 48% for patients admitted with non-true injuries.
Figure 6: All injuries, bed days
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
III
Gl
o 40
15
.•.
III 25
'§
10
;,;;
20
*'
.C'
5
030
35
0,1
2
3-7
8-14
Bed days
.. 10 ..
15-42
> =43
Figure 7: True injuries, bed days
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
::3
•..
c:
0c:::30
.•.
'C'
'2
=
'/:
'E
'*
Cl
CIl
10
60
20
40
30
0
: 50
0,1
2
8-14
3-7
15-42
> =43
Bed days
Figure 8: Non-true injuries, bed days
Private Hospital Admissions, Victoria, 18 months, Jan 1993 - Jun 1994
•..
.•.
!/l
30
..
0 15
c:
.91
0C 105
'*
,5
.2. 20
::3
CIl
0,1
025
2
8-14
3-7
15-42
> =43
Bed days
3.4 Frequency by major causes of injury :
Six months, January 1993 to June 1993 compared with twelve months,
July 1993 to June 1994.
There was a total of 17693 admissions (9521 males, 8172 females) for injury into private
hospitals for the six months, January 1993 to June 1993 and 22846 (11971 males, 10875
females) for the twelve months, July 1993 to June 1994.
Figure 9 shows the number of presentations compared for the major categories of injury,
and Figure 10 shows the relative numbers of admissions for various major categories of
unintentional injury. The ratios for the 12 months to six months data are about 1.3, with a
range from 0.9 to 1.7. The results are similar for the three major transport injury groups,
See Figure 11. Figures 9, 10 and 11 are based on data in Table J in Appendix 3 .
.. 11 ..
Figure 9: Total males and females, % of all injuries for period
Private Hospital Admissions, Victoria, 6 months Jan 1993 - Jun 1993
compared with 12 months Jul1993 to Jun 1994
1.3
All injuries
All Non-true injuries
All True Injuries
Undetermined intent
6 months
I 0.7
[] 12 months
1.3
Intentional
Ra1io 12 m~lnths: 6 months
1.1
Unintentional
o
5000
15000
10000
20000
25000
Number
Figure 10: Major causes of unintentional
injury
Private Hospital Admissions, Victoria, 6 months Jan 1993 - Jun 1993
compared with 12 months Jul1993 to Jun 1994
I500
1000
2000
1500
3500
4000
3000
2500
4500
5000
Other
0
[] 12 months
1.4
L:J 6 months
Ratio 12 months: 6
'1.4
!
0.9
1.
Falls
Transport
Machinery
Poisoning
Figure 11: Transport injuries, number
Private Hospital Admissions, Victoria, 6 months Jan 1993 - Jun 1993
compared with 12 months Jul1993 to Jun 1994
1.3
Motor vehicle traffic
6 months
Motor vehicle
non-traffic
o 12 months
Non-motor
vehicle traffic
o
100
200
300
Number
.. 12 ..
400
500
600
3.5 Frequency by 5-year age group and sex:
Six months, January 1993 to June 1993 compared with twelve months,
July 1993 to June 1994.
Figure 12 shows the relative distribution by 5-year age group of the admissions contained
in the 6 months and 12 months data. The ratio of 1.3 for the two groups of data was again
apparent, with a range of 1.1 to 1.6. There relatively more injuries in the over 60 years age
groups in the 1993/1994 data as in the 1993 data.
Both sets of data showed a similar distribution of male to female admissions. (Figure 13.)
There were relatively more males and females in the over 60 years age groups in the
1993/1994 data, which reflected the overall distribution pattern for the totals.
Figure 12: Distribution by 5-year age group
Private Hospital Admissions, Victoria, 6 months Jan 1993 - Jun 1993
compared with 12 months Jul1993 to Jun 1994
:l•..
I
1800 012
mo
800
6 mo
600 ~.IiIlII
E 1000
2000
1400
400
1600
1200
Z
~
~/\f,
~
JN
,
6IIf,
~
<
<'l
Lt)
to
lXl
lXl
'll)t)
L
r-..
L
t)
C
C
l)
..:.
11
rs)
Figure 13: Male/female distribution
by 5-year age group
Private Hospital Admissions, Victoria, 6 months Jan 1993 - Jun 1993
compared with 12 months Jul1993 to Jun 1994
.tl
BOO
600
Z::IE 1400
r-l.6.mo.f ••male •...
1000
200
0
1200
~ 400
11
•
~
"
<t
N
c'"
'"
'"
'"
'...
<t
<t
'<t
1\
."'
.co
;,";,o
6~
.;,
11
"
-
•
• 12 mo males
-=-
N
.. 13 ..
12 mo females
.. 14 ..
4.
Results: Private Hospitals comparedwith Public Hospitals
4.1 Comparison of 6 months private hospital data with 12 months private
hospital data and 12 months public hospital data.
For the twelve months July 1992 to June 1993, the Victorian Inpatient Minimum Dataset
contains data relating to private hospitals for the six months from January 1993. For the
1993/1994 financial year, there is data derived from private hospitals for the entire twelve
months.
As can be seen from Table 4, of the 95684 cases of injury admission for the financial year
1992/1993, 18.5% relate to private hospitals. Similarly, of the 114909 cases of injury
recorded for the 1993/1994 financial year, 19.9%, or 22846 cases, relate to private
hospitals.
From the table, there is an increase of 19225 cases of injury admissions to public hospitals,
24.7% from 1992/1993 to 1993/1994. Had the private hospital admissions increased at the
same rate, 44126 cases could have been expected in 1993/1994. See also comments in
3.2 above concerning the apparent shortfall in private hospital cases during 1993/1994.
TABLE 4:
Comparison of Private Hospital Injury Admissions
Public Hospital Injury Admissions, Victoria,
July 1992 to June 1994
18.5
42955
35036
months
Ptotal
rivate
114909
77991
18.1
18.9
43208
52476
95684
20.6
22846
10875
19.9
4
917693
8172
9521
1883
2063
of
total
months
Total
%
Total
Twelve
Public
Six
62151
52758
19.3
11971
5
0180
Private
Private
of 1992/1993
%
Hospitals
4.2
with
1993/1994
Hospitals
Age group and sex distribution comparisons
Figures 14, 15 and 16 are derived from Table K. See Appendix 3.
Relatively, fewer younger persons present to private hospitals for injury to age 25 years,
while from this age, relatively more are admitted to private hospitals than public hospitals.
This is seen in Figure 11. This pattern is duplicated when the data are examined by sex.
For both males and females, private hospitals seem to admit a higher proportion of persons
OVGr25 ycc;:rs than do public hospitals. (Figures 12, 13)
.. 15 ..
Figure 14: Five-year age group distribution,
males and females, % by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
-
9
..
=...
..
8 l-
-
.'
=...
......
• hnm
•••••
h•
"-
..
•••••••••••
.......
..•....
1:_ 7
111
'i:: 6
r-.
'1
fII
o u
I-.. r-
•••• h ••
r-
--
-
fII.a::l
.-
E.e-5
~i>
4
'0 'I:
•• .9-
3
'#.
2
"tl
QI
«I
1
o
,
N
~
6i'~
•...
•...
co
Lt)
<Xl
<
L
'l
e<'l
nt)
11
anaen
n
,
11
Figure 15: Five-year age group distribution,
males, % by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
0
1Il.a
r-
12
.-c_
::l
1Il-cQj
.2.!:!
"''la
iii'c
426
E >Do 8
ES:
~
III
cu
10
mm.;=m 0
-
..
....
..
..
u ••••••
-- r-
-
U
')
I-
]
..
..
Public Hospitals
-
Ol
co
Ii>
co
Ol
'<t
t[)
I
oI
IX)
IX)
IX)
h
f'o.
t[)
f'o.
11
Age Group (Years)
Figure 16: Five-year age group distribution,
females, % by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
III
cuS:
r-
f-
0
C _ 12
->
.•..
42
'#.
'iij.!:!
.!!!
2i 8
E'~
cu "'
'i~
Ea 6
0
10
I
I-
o
-
r-
-
..
•.:::.::'"
I- Private Hospitals
--
Public Hospitals
"
'<t
I
;:I;
~
J,
(')
~
co
~
~
Age Group (Years)
.. 16 ..
11
I
5il
;j1j
co
Ol
co
J,
co
"
'<t
t[)
IX)
IX)
IX)
h
11
4.3
Bed days comparisons
In general, patients appear to spend much the same period of time in private hospitals as
public hospitals for the same type of injuries. Comparisons of the percentage of grouped
numbers of days for a few injury groups are shown in Figures 17 to 20. There is a
tendency that very long-term stays (over 6 weeks) are more likely to be in public, rather
than private hospitals. For fall injuries (Figure 19), the proportion of stays of three days to
six weeks tend to be more common in private hospitals than public.
Figure 17: All injuries, bed days, % of all injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
?P-
-~ 3020152510405o
•..
:l0
G)
.e.~
G)
'§
J:J
-;;
:E'
'ii
;g 35
0,1
•
Private Hospitals
LJ Public Hospitals
2
8-14
3-7
15-42
> =43
Bed days
Figure 18: Motor vehicle traffic injuries, bed days, % of motor vehicle traffic injuries
by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
]"
35
~ 30
Q,
~
•
.:!:
..s.
III
Private Hospitals
25
Public Hospitals
20
G)
'§ 15
:E'
!>
10
:E
'0
5
?P-
0
0,1
2
8-14
3-7
Bed days
.. 17 ..
15-42
> =43
Figure 19: Fall injuries, bed days, % offall injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
35
u
~ 30
!
•
='
Private Hospitals
CL
25
'"
LJ Public Hospitals
>
]. 20
III
.!
15
='
'2'
;;;; 10
'"
.•.
.•.
o
5
*"
o
0,1
2
8-14
3-7
15-42
> =43
Bed days
Figure 20: Non-true injuries, bed days, % of non-true injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
III
i
30
105
='0- 15
'2'
~='
'*'
c§ Gi 20
g
IIIIII Q.
•••
CL
.;::
::J
.- "C
.Q
0,1
•
Private Hospitals
025
D Public Hospitals
2
3-7
8-14
Bed days
.. 18 ..
15-42
> =43
4.4
Comparisons by major injury groups
NOTE: Numbers on the x-axes in the charts in this section relate to 18 months private
hospital cases and 12 months average public hospital cases.
4.4.1
True/non-true
injuries
The ratio of true to non-true injury admissions for public hospitals is 2.41 (70.7:29.3),
whereas for private hospitals it is 1.54 (60.7:39.3). This suggests that relatively, there are
considerably more non-true injuries in private hospitals than public hospitals. (Figure 21).
Figure 21: True/non-true injuries, % of all injuries for hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
All injuries
•
Private Hospitals
o Public Hospitals
All non-true injuries
of all injurif;ls (private/pyblic)
All true injuries
70.7
10000
o
20000
30000
40000
50000
60000
70000
Number
4.4.2
Non-true injuries
The two major groups of non-true injuries are medical injuries (which include medical
misadventure, post-operative complications and adverse drug effects) and late effects.
When these two categories are compared, it is apparent from Figure 22 that admission to
private hospitals due to late effects of injury are higher relative to medical injuries when
compared to public hospitals.
Figure 22: Medical injuries and late effects, % of all injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
•
Private hospitals
o
Late effects
Public hospitals
:
% of all injuries (priva~e/public)
33.3
Medical injuries
27.~
All non-true injuries
o
2000
4000
6000
8000
10000
Number
.. 19 ..
12000
14000
16000
18000
20000
4.4.3 Comparison of intent of injury
From Figure 23, it can be seen that when injury by intent is examined, assuming similar
disclosure rates and coding procedures in the two types of hospital, intentional injury cases
present to private hospitals about eight times less frequently,' relatively, than they do to
public hospitals when compared with unintentional injuries, which occur at about the same
relative frequency.
Figure 23: Injury intent, % of all injuries for hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
0.2
Undetermined intent
•
0.3
Private Hospitals
D Public
Hospitals
..
0.9
injuries (private/public)
Intentional
7.5
Unintentional
6219
o
5000
10000
15000
20000
25000
30000
35000
40000
45000
Number
4.4.4 Intentional injury
Figure 24 shows the relative frequency of self-inflicted injury and intentional injury inflicted
by others at both private and public hospitals. It seems that self-inflicted injuries are
admitted to private hospitals about twice as often as assault injuries. This compares with
about 20% more frequent self-inflicted injury admissions to public hospitals.
Figure 24: Intentional injuries, % of all injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
Inflicted by other
•
Private hospitals
D Public
hospitals
of all injuries (private/public)
Self-inflicted
All intentional injuries
o
1000
2000
3000
Number
.. 20 ..
4000
5000
6000
4.4.5 Unintentional injury
Table 5 and Figure 25 show the distribution of unintentional injury type in private hospitals
and public hospitals. It is immediately obvious that the very high proportion of "other"
injuries could be distorting the true pattern of unintentional injury in private hospitals.
Notwithstanding this, transport injuries present less frequently to private hospitals than
public hospitals, as do poisonings and fire/burns/scalds. While falls may be presenting less
frequently at private hospitals, it is not clear, given the high "othe~' frequency.
Hit/struck/crush
hospitals.
injuries seem to be relatively more common at private hospitals than public
TABLE 5
Unintentional injury groups, % of all unintentional injuries by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
Public hospitals
%
Frequency
9294
106
2087
1042
16923
1234
1104
4047
1094
3027
2723
Transport
Near-drowning
Poisoning
F ire/bu ms/sca Ids
Falls
Nat'l/environment
Choking
Hit/struck/crush
Machinery
Cutting/piercing
Other
Total unintentional
Private hospitals
Frequency
%
11
21.8
0.2
4.9
2.4
39.6
2.9
2.6
9.5
2.6
6.4
6.4
11
1656
6.9
8
0.0
106
155
8669
224
246
3326
325
904
8540
0.4
0.6
35.9
0.9
1.0
13.8
1.3
3.7
35.3
24159
42683
* = % of total unintentional injury
Figure 25: Unintentional injuries, frequency
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
Other
Cutting/piercing
Machinery
•
Private hospitals
o Public hospitals
Hit/struck/crush
Choking
Nat'l/environment
Falls
Fires/burns/scalds
Poisoning
Near-drowning
Transport
o
2000
4000
6000
8000
10000
Number
.. 21 ..
12000
14000
16000
18000
4.4.6
Transport
injury
The ratios of public to private cases of transport injury are 3.8,3.7 and 2.5 for motor vehicle
traffic, motor vehicle non-traffic and non-motor vehicle traffic respectively. This suggests
that cases of non-motor vehicle traffic, such as pedal cyclists are horse riders, are more
likely to be admitted to private hospitals than for the other two categories.
Figure 26: Transport injuries, frequency. % of all injury by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
2.5
Motor vehicle traffic
9.4
Motor vehicle
•
Private hospitals
non-traffic
o Public hospitals
···
···
··
Non-motor
vehicle traffic
% of all inj~ries (private/public)
3.2
o
1000
2000
...
...
..
3000
4000
5000
6000
7000
Number
4.4.7
Sport injury
A comparison of sport injuries as measured by falls and collisions in sport, indicates that
private hospitals admit relatively more patients with sport injuries, especially those with an
external cause of cOllisions in sport. See Figure 27.
Figure 27: Sports injuries, frequency, % of unintentional
injury by hospital type
Private Hospital Admissions, Victoria, 18 months Jan 1993 - Jun 1994
compared with Public Hospitals Admissions, average annual Jul1987 to Jun 1993
6.4
Sport injuries
5.1
Collisions in sport
4.2
Falls in sport
•
Private hospitals
o
Public hospitals
% of urlintentional injuries (private/public)
o
500
1000
1500
2000
2500
Number
.. 22 ..
1·1)1111
d .1
5.
Discussion and recommendations
5.1
Method
The data for 1993/1994 contained in the Victorian Inpatient Minimum Dataset, showed
there were a total of 114,909 admissions to Victorian hospitals, 92,063 of which were to
public hospitals. For the previous 12 months (1992/1993) there were 95,684 admissions
(77,991 to public hospitals), and for 1991/1992 there were 69,439. In 1991/1992, and in
prior years, private hospital data were not included.
To 1991/1992 the increase in admissions was about 2% per annum. Between 1991/1992
and 1992/1993 the increase in admissions to public hospitals was 11 %, and between
1993/1994, the increase in admissions to public hospitals was 18%. This rapidly increasing
rate of admission to public hospitals is possibly due to a combination of the introduction of
case-mix funding and a shift away from private hospitals. It is again recommended that the
effect of case-mix funding on admission policies to both public and private hospitals be
formally investigated.
The quality of the data being provided by the private hospitals to VIMD appears to be
inconsistent. The unacceptably high numbers of injuries classified as "other" could be
distorting the true pattern of unintentional injury in private hospitals and may reflect poor
coding practices by some private hospitals. Even within major injury groups, it is
disappointing for research and prevention purposes at least, to find so little disaggregation
of injury. For instance in Tables A and 0 (Appendix 3), cutting/piercing injuries seem
largely to have been caused by "other" means.
A further feature of concern is the variability between the private hospital data for 1992/
1993 and 1993/1994 where in the latter year, there seems to have been even less
disaggregation of major injury groups than in 1992/1993. Compare hit/struck/crush or
cutting/piercing injuries in Tables A and D.
Recommendations
1.
The Department of Health & Community Services should continue to monitor the
quality of the data being included in the Victorian Inpatient Minimum Dataset,
particularly the data derived from private hospitals, and make the results of their
monitoring readily available.
2.
Poor quality data collections should be referred back to the hospitals of origan as part
of a routine quality control process.
3.
A formal study should be undertaken urgently to determine the effect of case-mix
funding on admission policy of public and private hospitals and how this might affect
any analysis of the Victorian Inpatient Minimum Dataset for injury prevention
purposes .
.. 23 ..
5.2
Frequency, major causes, age and male/female distribution.
As pointed out in a previous report,1 calculation of injury rates based on the Victorian
Inpatient Minimum Dataset will need to take account of the injuries being admitted to
private hospitals if they are to be satisfactorily accurate. To date, injury rate calculations
have mostly assumed all injuries present at public hospitals so that Victorian population
statistics are used as a denominator. From this study. it is apparent that about 20% of
injured Victorians are admitted to private hospitals, although about 4% of these are
transfers from public hospitals. This represents in excess of 20,000 cases per annum
based on the 18 months data available. That there is such a high number of injuries
admitted to private hospitals is of interest. It might have been expected that injuries were
more likely to be encountered in public hospitals via emergency departments.
As the six months data is claimed to include data from about 60% of private hospitals, and
the twelve months data was expected to include data from about 95% of private hospitals,S
it could be anticipated there would be about three times as many cases in the
data as the
6 months
data (2x95/60), or about 56000 admissions.
12 months
There were, however,
22846 (11971 males, 10875 females) injury admissions to private hospitals for the twelve
months, July 1993 to June 1994, a ratio of 1.3 for 12 months to 6 months data. This ratio
is generally confirmed for various major categories of injury, as shown in Figure 6.
Alternatively, most of the injuries which present to private hospitals take place in the first
60% of private hospitals reporting.
As for public hospitals, medical injuries comprised the most frequent major group of injury
as classified by E-code. About 60% of the private hospital injury admissions were found to
be true injuries, and almost all of these were unintentional. Falls were the most frequent
unintentional injury type, followed by hit/struck/crush injuries, then transport. The high
numbers of hit/struck/crush injuries may reflect the admissions due to collisions in sport to
specialist private hospitals, or insured cases of workplace injury. Without the ability to
identify hospitals, the identifiers having been deleted before the data was supplied to
MUARC, it is not possible to confirm this.
Admissions
due to intentional injury, both self-inflicted and assault, were not high.
The age and male/female distributions of injury admissions to private hospitals seem to be
similar to those for public hospitals. See next section.
The analysis of private hospital injury admissions does not change the emphasis currently
being placed on injury prevention activity.
Recommendations
4.
To obtain true Victorian injury rates, the total data in the VIMD should be used. To
obtain trends in rates, it may be necessary to restrict data analysis to public hospital
admissions for the next few years until the bias due to the inclusion of private hospital
data is no longer important.
5.
The Department of Health and Community SeNices should consider making available
to MUARC private hospital identifiers for agreed research purposes .
.. 24 ..
5.3
Comparisons with public hospital data
For statistical purposes, it is important to know if the data in VIMD relating to private
hospitals is very much different from that for public hospitals. Generally, this study has
shown that it is probably not, but investigations in certain areas will need to take into
account that there are some differences.
Private hospitals appear to admit relatively fewer young persons, of either sex, up to the
age group 20-24 years. It would be reasonable to ignore the cases of private hospital child
and adolescent injury in VIMD for calculation of rates and trends, should that be expedient.
On the other hand, from 20-24 years, private hospitals admit significant numbers of
patients. These cases should not be ignored.
The relative proportion of true to non-true injuries is lower for private hospitals than public
hospitals, both late effects and medical injuries being relatively more frequent. Patients
appear to be admitted to private hospitals for late effects of injury with a relative frequency
three times greater than public hospitals (6% of all private hospital injury admissions
compared with 2% of all public hospital admissions). This is not a surprising finding. The
treatment of late effects of injury would seem to be an appropriate role for private hospitals
for those patients who wish and are able to be admitted to them. However, the
circumstances of medical injuries in private hospitals need investigating. As for public
hospitals, it ought to be determined why medical injuries constitute the major cause, by
frequency, of private hospital injury admission. It is speculated that the majority of cases
are the result of multiple procedures being carried out on elderly patients following the
primary cause hospitalisation, which was probably not an injury.
The general lack of emergency department facilities at private hospitals, the current low
rate of private hospital insurance, and possible non-disclosure, probably account for the
low admission frequency of intentional injury cases. Intentional injury constituted only 0.9%
of private hospital injury admissions, compared to 7.5% of public hospital injury admissions.
Unfortunately, the interpretation of the results of the analysis of unintentional injury cause
has been made imprecise because of the high number of cases coded as "other" (32% of
total unintentional injury admissions). Generally, it appears transport injuries present less
frequently at private hospitals, again, probably due to the lack of emergency department
facilities, but sporting injuries are not uncommonly admitted to private hospitals. As there
are known to be private specialist sports injury treatment hospitals, this finding is able to be
accounted for.
Hospital bed use patternsfor private hospitals are similar to public hospitals.
a tendency for patients to stay for shorter periods in private hospitals.
There may be
Recommendations
6.
As private hospitals tend to admit older (than 20-24 years) patients for injury more
frequently than public hospitals, calculation of rates should take into account private
hospital data for older age groups .
.. 25 ..
7.
A formal detailed descriptive epidemiological study should be undertaken to
determine the reasons for the high numbers of medical injuries appearing in public
and private hospital data. This may lead to a proper justification for the exclusion of
these injuries from further injury prevention research and provide useful information
for the evaluation of medical procedures and hospital quality control programs
8.
Sports injury studies should take into consideration the admission of patients with
such injuries to private hospitals .
.. 26 ..
6.
References
1.
Watt GM. Hospitalised injuries Victoria, July 1987 - June 1993. Monash University
Accident Research Centre. Report No 67. Melbourne: Monash University Accident
Research Centre, 1995.
2.
US Department of Health. The international classification of diseases, 9th revision.
Clinical modification (ICD-9-CM). Ann Arbor, Michigan: Commission on Professional
and Hospital Activities, 1986.
3.
SPSS-X Version 4.1 [Computer program]. Chicago: SPSS Inc., 1988.
4.
Microsoft Excel Version 4 [Computer program]. Redmond, Washington: Microsoft
Corporation, 1992.
5.
Department of Health and Community Services. The Victorian Inpatient Minium
Database: An overview. Melbourne: Department of Health and Community
Services, Acute Health Services, 1994.
.. 27 ..
.. 28 ..
,1;li,1
Appendix 1
ICD-9-CM E-codes used for desegregation of injury causes
Injury Type
E-codes
Transport (total)
Motor vehicle traffic
800.0-848.9 not 830,832
810.0-819.9
Motor vehicle driver
810.0,811.0,
810.1,811.1,
Motor vehicle passenger
..819.0
..819.1
810.2,811.2, ..819.2,810.3,811.3, ..819.3
810.6,811.6, ..819.6
Motorcyclist
Pedal cyclist
Pedestrian
810.7,811.7, ..819.7
Motor vehicle non-traffic
820.0-825.9
Motor vehicle
820.0, 821.0, ..825.0, 820.1, 821.1, ..825.1
820.2, 821.2, ..825.2, 820.3, 821.3, ..825.3
820.7,821.7, ..825.7
Motorcyclist
Pedestrian
Non-motor vehicle traffic
Railway
Pedal cyclist
Animal being ridden
Water transport
Air transport
800.0-807.9
826.0-826.9
828.0-828.9
831.0-831.9, 833.0-838.9
840.0-845.9
Near-drowning
Pool
830,832,910.0-910.9
910.8
Poisoning
Heroin/opiates
Other drugs and medications
Other solids/liquids
Gas/vapour
850.0-869.9
850.0, 850.1, 850.2
850.3-858.9
860.0-866.9
867.0-869.9
Falls
Stairs
Ladders/scaffolds
Building/structure
Playground equipment
Different level, other
Same level/trip/slip/stumble (not sport)
Falls in sport
Fracture, cause unspecified
Other falls
880.0-888.9
880.0-880.9
881.0-881.9
882.0-882.9
884.0
884.1-884.9
885.0-885.9
886.0
887.0
883.0-883.9, 886.9, 888.0-888.9
Fires/burns/scalds
House fires
890.0-899.9,924.0-924.9
890.0-890.9
893.0-893.9
924.0
924.1-924.9
Clothing ignition
Steam
Hot substance/object
.. 29 ..
Natural/environmental
900.0-901.9, 904.0-909.9
Excessive heat/cold
900.0-901.9
906.0
905.0-905.9
Dog bite
Venomous bite
Other animal bite/attack
Choking/suffocation/foreign
906.1-906.9
body
Aspiration of food
Aspiration of non-food
Suffocation
Foreign body in eye
Foreign body in other orifice
Hit/struck/crush
By falling object
Collision in sport
Caught/crush
Other hit/struck/crush
911.0-915.9
911.0
912.0
913.0-913.9
914.0-914.9
915.0-915.9
916.0-918.9
916.0
917.0
918.0
917.1-917.9
Lifting machinery
Earthmoving machinery
919.0-919.9
919.0
919.3
919.4
919.2
919.7
Cutting/Piercing
920.0-920.9
Power tools
Power household
920.0, 920.1
920.2
Knives
920.3
Hand tools
920.4
Other cutting/piercing
920.5-920.9
Machinery
Farm machinery
Metalworking machinery
Woodworking machinery
Other
Firearms
Explosion
Electric current
Over-exertion
Intentional - Self-inflicted
Poisons, solids/liquids
Firearms
Cutting/piercing
Intentional - Inflicted by other
Unarmed fight/brawl
Firearms
Cutting/piercing
Child battering/maltreatment
922.0-922.9
921.0-921.9, 923.0-923.9
925.0-925.9
927.0
950.0-958.9
950.0-950.9
955.0-955.9
956.0-956.9
960.0-968.9
960.0
965.0-965.9
966.0-966.9
967.0-967.9
.. 30 ..
Undetermined intent/other
Undetermined, firearm
970.0-976.9,978.0-978.9,980.0-988.9,990-998
985.0-985.9
Undetermined,
980.0-980.9
drugs/poisons
Medical misadventure
870.0-876.9,878.0-879.9,
870.0-876.9
Post-operative complications
878.0-879.9
Adverse drug effects
930.0-949.9
Late effects
929.0-929.9,959.0-959.9,969.0-969.9,
Medical injuries
.. 31 ..
930.0-949.9
..999.0-999.9
.. 32 ..
11111.1
Appendix 2
Examples of injury types for injury categories
Injury categorylDeflnltion
Example
Motor vehicle traffic
Collision between an automobile and a pedestrian,
animal-drawn vehicle, parked vehicles and stationery
A motor vehicle accident occurring
on a public highway.
A motor vehicle includes an
objects, such as light poles.
Fall from a bus while alighting.
automobile, bus, construction
machinery, motorcycle, truck.
Includes towed vehicles.
Motor vehicle non-traffic
Overturning of off-road motorcycle.
Collision of racing car on speedway.
A motor vehicle accident occurring
entirely in any place other than
public highway.
Non-motor
a
vehicle traffic
Collision between a bicycle and pedestrian.
Horse-rider thrown from animal.
Accidents involving vehicles other
than motor vehicles. Vehicles
include trains, horse-drawn
buggy, harnessed animal,
bicycle, bus, tram.
Boating and aircraft accidents.
Poisoning
Paraldehyde mistakenly taken instead of paracetamol.
Ingestion of insecticides.
Accidental poisoning by exhaust gas from a garaged
motor vehicle.
Accidental poisoning by drugs,
medicinal substances, biologicals,
solid, liquid or gaseous
substances.
Falls
Fall from a ladder.
Tripping on an escalator.
Falling through a roof.
Swimming pool diving accident.
Falls in sport.
Rollerblading accidents.
Fire/burns/scalds
Carbon monoxide poisoning from house fire.
Ignition of nightwear.
Scalding by boiling water and steam.
Caustic burn by over cleaner.
Burn caused by electric radiator .
.. 33 ..
Natural/environmental
Dehydration caused by lack of water.
Bite of venomous snake, ant, jelly fish.
Bite of dog, rat, non-venomous animal.
Lightning strike, torrential rain, landslide, dam collapse.
Submersion from overturned boat.
Near-drowning
Fall with submersion while water skiing.
Swimming pool, bathtub submersions.
Choking/suffocation/foreig
body
n
Fish bone caught in throat.
Aspirated regurgitated food.
Suffocation by plastic bag.
Metal grindings in the eye.
Objects wedged in the ear.
Hit/struck/crush
Struck by faIBng tree branch.
Kicked by a horse.
Stepped on while playing football.
stick during game.
Crushed in a crowd.
Struck by a hockey
Hit by air rife pellet.
Finger jammed in cupboard door.
Accidental hit with a hammer.
Pinned under a tractor.
Machinery
Striking by fork lift truck.
Caught in metal-working lathe part.
Cut by bench saw.
Accidentally stapled by staple gun.
Cutting/piercing
Burn when electric beater caught fire.
Caught finger in electric fan.
Cut hand with chisel.
Stood on nail.
Other non-intentional
Accidentally shot in the foot by rifle bullet.
Cut by exploding aerosol can.
Electric shock from faulty electrical wiring.
Cardiac fibrillation form faulty electrical transformer.
Blistering by sun-tanning lamp.
Overexertion caused by lifting heavy object.
Intentional
Attempted suicide by overdose of tranquillisers, motor
vehicle exhaust, hanging, suffocation by plastic bag,
firearms, jumping from bridge, lying on train tracks,
crashing of motor vehicle.
- self-inflicted
Includes suicide attempts and
para-suicide.
Intentional
- inflicted
by others
Includes injuries inflicted another
person with intent to injure or kill,
by any means.
Unarmed brawls, fights.
Attempted strangulation.
Rape.
Pushing from a high place.
Assault by poisonous substances, firearms, knives.
Child battering by parent.
.. 34 ..
Undetermined intent· non·
intentional
After a thorough investigation, it
cannot be determined with the
injuries are non-intentional,
suicidal or homicidal.
Medical
Accidental haemorrhage during surgical procedure.
Includes misadventures during
Accidental puncture during administration of enema.
Foreign object left in body during a surgical procedure.
surgical and medical care
(medical misadventure), surgical
and medical procedures as the
cause of abnormal reaction or
later complication (post-operative
complications), and drugs causing
adverse effects given in
therapeutic doses (adverse drug
effects).
Failure of sterile precaution during endoscopic
examination.
Excessive amount of blood during blood transfusion.
Inappropriate temperature in local application.
Bacterially-contaminated fluid infused.
Suture failure in operation.
Removal of other organ.
Endotracheal tube wrongly placed during anaesthetic
procedure.
Late effects
Conditions occurring as sequelae
one year or more after accidental
injury .
.. 35 ..
.. 36 ..
Appendix 3
.. 37 ..
ate
Hospital
11
414
83
12
830
154
20
9
16
9
2
119
5
11
10
3
23
16
0
23
1
21
15
1-4
6
567
6
35927
8
441
406
079
8740
661
728
418
2
113
517
415
173
3
058678
66
3
55
97
67
5
28
41
410
11
70
81 10-14
7
2
13
25
79
42
11
59
441
68
37
8
9
6
28
4
227
4
2
0
10
11374
1
453
0522
313
1
515
7
1
32
45
74
34
27
51
28
22
18
13
91
58
20
15
21
19
1232 15-19
1056
917<1
11 25-29 30-34
0 35-39 40-44 45-49 50-54 55-59 60-6465-69
01
5-9
20-24
Non-motor vehicle traffic (total)
Railway
Six months,
1(Males
January
1993Females)
to 30 June 1993
Injury
Admissions,
Victoria
Total
and
TABLE
A
70-7475-79
80-84
>=85 All
<0
140
46
75
31
34
35
552
196
103
2815
665
16
22
29
22
33
2176
623742
40223
202
142
26
53
118
38
720
11
24
158
178
14
13
280
304
578
3754
0107
130
14
71188
5024
17
3406
8637
00
12
9830710-14 15-19 20-24
127
20
23
26
70
30
10
47
4161
5Choking/suffocation/
194
87
156
167
224
104
111
382
012
117
106
32
264
04029
013
21
28
70
107
10
155
1-4
1371
1134
47
258
244
944
59
152
43
17
40285
62753
10
24
131
29
021
085
292
178
033
31
948
052
00
1397
6130
85
3567459
0915
12
10
52
71
125
60
236
168
1063
114
140
244
20
24164
107
25
24
12
5318986
74
125
282
212
29
63939
243
94
07
1415
<1 125-29 30-34
20410 35-39 40-44 45-49 50-54 55-59Table
A (Total six
months
5-9
60-6465-69
70-74
75-79 1993)
80-84
foreign
body (total)
>=85 All
941
189
179
011
54498
4277
013
081
613
90840
243
47363
1291
03
143
019
85
617
51
420
66
20
23
4530726
3727
26
3477
51
62
40
16
15
80
156
1-4
32
1271
509
302
407
8628
360
469
79412
304
17
30
017693
055
500
2965
12
2252
21
96
99
14
526
129
33
85
1346
15
331
53
67
1635
63
45
12
103
234
1436
364
97
53
56
449
450
216
397
300
57
306
25
30
23
92
98
48
88
568
8525
6318
349
859
306
35
170
101
45
6681
183
314
71
19
937
13
111
467
456
37
313
28
954
230
428
274
492
136
352
46
751
378
421
368
443
449
218
546
423
388
609
189
5129
529
410
575
313
11
246
356
325
524
404
1260
1077
11
64
2497
43
39
130
120
17
57
142
123
26
28
41
24
16
33
18
28
426
6110
49
42
<1
51297
15
72273
16
12
14
166
92
53
58
68054312810-14
186
474
144
473
539
227
742
155
196
3767
4379
4910
72
160
1200
459
1 1381
050411266 117740-44
223
288
65
83
71
718
243
893
960
11583
1217
5-9
15-1920-24
25-29
30-3435-39
45-49 50-54Table
55-59A 60-64
70-7475-79
80-84 >=85 All
345
898
1110
1019
1531
1051
1034
859
1150
Other
means
(Total65-69
six months
1993)
Inflicted by other (total)
1
8
6
21
11
913
97
0
2488
150
107
33
22
422
668
39
5
12
34
21
113
27
11
14
6
11
0516
46
17
2
6
0
3
18
61
84
35
16
17
2
905
3
1
1242
0
13
12
2047
1-4
292
780
592
304
929
667
63
43
12
20
130
9
1108
10
0243
0137
31
1276
40
53
24
23
12
22
7
8
1
3
26
1
4
1
31
10
106
11
113
209
160
<1 6 traffic (total)
7
74
001
49
6571
5-9
10-1415-1920-2425-2930-3435-3940-4445-4950-54
Non-motor
vehicle
Railway
Six months,
1 January
1993 to 30 June 1993
Private Hospital Injury
Admissions,
Victoria
Males
55-59 60~4
65~9TABLE
70-74B 75-79 80-84
>=85 All
I\)
012
3825
46097
325
256
0
20
52
11
5310-14 15-1920-24
41
3831
102
942
22
128
72
25
59
13
202
20
645
512
158
47
044
23
11
8Choking/suffocation/
23
12
11
65
47
23
28
7345
23
19
6116
10
28
21
12
336
423
699
36
135
136
500
185
6542
4018
452
761
2105
54746
7
2319
413
32
76
62
301
170
117
53
53
08
62217
10
53
238
0163
991
45
633
108
854
108
94
231
38
56
32
19
18
148
201
122
16
15
093
1-4
35
21
11
424
41
39
13
31
8117
480
311
45
03
33
19
1
110
107
134
70
105
590
20
15
110
188
<1
17
2011
5-9
25-29
30-34
35-39 40-44 45-49 50-54 Table
55-59B60-6465-69
(Males six 70-7475-7980-84
months 1993) >=85 All
foreign body (total)
c..>
300
2682
0212
01538
5287
025
43713
1134
37
103
61
417
370
158
179
101
52
1-4
16
17
12
9139
97
Other
40110-1415-1920-2425-2930-3435-3940-44
16
33
58
75
21
150
27
31
569
20
943
3175
4244
76
228
264
36
2536
250
245
317
359
347
101
73
192
59
43
107
722
104
46
770
12
118
106
46
45
74
14
76
87
51
225
310
38140
13
155
173
175
160
182
220
315
20
48
55
1
66
55
1091
22
686
294
23
674
795
497
42
36
601
11
307
14
0232
122
653
6669
321
269
132
920
21
323
672
027
33
5715
70
89
80
53
210
230
2018
2180
65
148
187
108
264
328
5
16
11
140
11
80
21
10
429
2105
131
4109
1114
10
155
161
519
2321
2455
12
981
29
237
177
15
221
241
313
293
95
193
847
489
310
970means <1
00541
2852
972
113
212
92
712
163
768
761
616
464
203
9521
1098
645
476
489
341
5-9
(Males 70-7475-7980-84
six months 1993) >=85 All
45-49 50-54 55-59Table
60-64B 65-69
Private Hospital
46
8
0
19
49
18
0
305-9
1
320
2
6
018
1
3
44
82
10
2
3
53110-14 15-19 <1
5
2
6
7
75
28
4
13
10
10
210
5
1
18
7
15
28
4
8
304
23
12
3
26
2
0
68303
1
2
01
75
364414
022
528246
013
5238
311
1394803
16
1
0
147
4
1
2
104
1-4
239
198
206
24
159
138
11
15
5
.4
21
31
11
18
16
12
11
0 35-39 40-44 45-49 50-54 55-59
137
77
260
454
277
610
249
276
213
240
161
5 25-29 30-34
20-24
Non-motor vehicle traffic (total)
Railway
Six months,
1 January
1993 to 30 June 1993
Injury
Admissions,
Victoria
Females
60-6465-6970-7475-7980-84
TABLE C
>=85 All
0'1
1
66
031
1763
23156
10
926
44
15
15
10
14
16
18
32420
17
16
30
13
74
31051080
27
25
065-9
00
61
68
108
12
57
5923
810
157
104
23
06530
2332
34
13
32
45
32
5935
6023759
1-4
10
17
11
147
24
37
27
12
55
15
840913
247
846
19
4752
8513
53
43
52
50
23
12
820
50
194
140
17
83
110-1415-1920-2425-2930-3435-3940-44
325
541
15
<1
0
20468
238
787
6165
03
13
55
51
374
53
102
184
62
44
358
188
143
312
0210
2349
Choking/suffocation/
foreign body (total)
C (Females
six months 80-84
1993) >=85 All
45-4950-5455-59 Table
60-64
65-69 70-7475-79
20
01411
101
308510-14
89
13
21
101
124
14
113
36
63
45
218
37
20
3247
62
30
110
12
72
4169
26
9282
463
137
67
22
77
8581
74
313
187
254
230
281
3258
59
42
39
7102
4169
25135
050
927
60
66
1231
540
789
89
50
96
15
12
136
25-9
79
33
01317
262
136
190
01471
206
1023
9672361
4390
16
313
28
11
268
220528
9104
416
15
283
37
11
10
199
3238
4914
77
22
15
1Cutting/piercing
971
12
27
1218
43
28319
47
172
259
23
116
129
24
191
207
17
128
66
116
277
29
10
3209
104
5236
102
20
119
1-4
46
657162
43187
299
59
2217
14
185
228
619
2730
13
137
77
0101
455
57
258
51
263
28
61
54
2252
282
505
450
121
34
137
25
193
19
157
126
151
183
278
213
131
96
3471
6
262
020-24
14
611
21
249
342
693
596
429
8172
80
433
762
638
532
422
534
530
152
15-19 <1
Other
means
0
530-3435-39
00150
25-29
40-44 45-49 50-54Table
55-59C60-64
65-6970-7475-79
(Females
six months 80-84
1993) >=85 All
12
15
36
15
178
37
1
0
118
030
025
14
10
868
428794
16
41
24
34
100
64
5
330
13
89
916
368
665
640
107
914
24
6
2
17
85
91
40
33
48
10
12
83
11
02
7
6332
5463
20
17
5
3
95
11
1-4
17
268
22
101
142
77
789
644
65
475
40
23
19
7
83
40
24
45
232
75
64
17
47
20
6
52
31
27
38
30
26
15
10
16
17
05381 10-14
14
00
2
20
0
43
16
61
1513
478
516
733
37
509
52
28
9
78
1052
1139
1352 <1
1206
940 25-29 30-3435-3940-44
42
23
26
35
33
532
571
25
1
0
483
692
24
12785
13
16
5-9
15-19
20-24
Non-motor
vehicle
traffic (total)
Railway
Twelve
months,
1
July
1993
to
30
June
Private Hospital Injury Admissions,
Total (MalesVictoria
and Females) 1994
45-4950-5455-59
TABLE D
60-6465-6970-74
75-79 80~4
>=85All
ex>
Aspiration
of non-food
Other
119
97
10
381
829
8189
64
66
671
06324
113
105
18
109
85-9
0254
373
14
3168
133
0493
278
14
12
56
159
199
506
27
135
136
149
124
20
19
21
31
7603
10
13
561
817
620
279
5130
10
6584
847
24
302
35
14
14
111
12
206
407
23
33
91
315
24
180
36
65
408
4
154
182
018
124
16
76
5
64730
240
29
54
130
124
278
158
573
88
92
282
16
16
1806
45
226
57
25
384
1283
107
183
193
25
313
14
18
171
196
23
1-4
1249
590
15
15
121
09
13
89
115
21
38
12980
1132
17
40
1955
47
12
235
44
26
137
72949
1344
11
30876510-14 15-19 <1
146
152
327
129
2796
17
Suffocation
0 35-39 40-44 45-49 50-54 55-59 60-64 Table
0 0
4
21
20-24
25-29 30-34
65-69 70-74
75-79
80-84months
>=85 All
Choking/suffocationl
0 (Total
twelve
Foreign body in eye
Iforeign body (total)
1993/1994)
means
902384
13
26
13
3430
8700
111
11
187
67
17
102
4493
64
28
5301
14
45
38
36
22
55
24
501
17
837
6389
30
347
12
5523
15134
10
083110-14
109
1-4
11
20
143
29
420
827
58
31
743470
1893
224
96
30
60
103
199
363
7418
40
50
396
150
305
339
380
453
20605
02778
3536
97
186
0103
8387
17
26
46
49
115
57
99
8572
817
112
461
283
311
16
239
24
105
193
168
71
270
14
124
34
44
193
482
368
337
696
246
616
526
619
4438
488
14
519
17
670
117
18
06973
94128
23
82
25
412
1078
1380
<1
1223
29
170
113
13
36
225
156
25
174
279
383
148
599
229
545
692
1329
65
744
1249
3929
722
19
130
52
157
48
851
9821
18
101
69
4042
92
13
662
473
11
566
483
7143
5576Other
960 25-29
133
749
568
126
340
259
609
955
814
33
95
7632
01619
10 30-34
006321 35-39
737
1143
13025
10
13
1122
941
1100
865
857
306
1089
1081
23
5-9
15-19
20-24
>=85 All
Table
0 1605
(Total65-6970-7475-7980-84
twelve 1565
months
522
1277
1743
1453
1395
129540-44
141145-49
121850-54
121055-59
141160-64
1619
12731993/1994)
1483
22846
Inflicted by other (total)
vate Hospital
8
19
9
10
14
014
3271
14
627
035
9210
38
5
605-9
17
129
125
43
127
43
1
17
54
22
01
25
4419
15
17
16
2189
1328
305
184
50374509
23
0678
36
61
31
13
47
70
23
15
209
6110-14
0
2
1
55
4
13
6
3
301
16
13
26
233
4
0
7
2215
35
1348126
714
5
1
50
16
144
11
15
1-4
46
323
70
57
196
132
173
160
27
41
45
432
20
27
18
11
42
567
38
18
65
58
<1 6 25-29 30-3435-39
774
84
7104
1009
94015-1920-24
001
Non-motor
vehicle traffic
(total)
Railway
Twelve Admissions,
months, 1 July
1993 to 30 June 1994
Injury
Victoria
Males
TABLE E
40-44 45-49 50-54 55-59 60-6465-6970-7475-7980-84
>=85 All
....•.
31151
022
2U14
1132
06370
5117
012
28
103
920
112
10
423
76250
45
13
21
8328
00
118
10
106
100
59
102
35
74
28
51
34
15
379510-14 15-19 <1
52
132
37
13
21
14
232
12
1446
1351
60
24
53
13
26
48
312
305
332
30
179
01
173
261
215
14
31419
81
280
11
11
19
10
15
80
520
643
386
94
114
37
52
114
133
103
170
141
131
72
58
79
859
420
219
1-4
17
29
2429
823
82
68
76
74693
197
16
11
55
0568
14559
79
31
115
79
60
75
746
13
0 0101 35-39 40-44 45-4950-54 Table
128
22
36
386
Choking/suffocationl
5-9
20-24 25-29 30-34
55-59 E60-6465-69
70-74
75-7980-84
>=85All
(Males twelve
months
1993/1994)
Iforeign body (total)
Other
means
0
9
10
4327
3111
60872110-1415-1920-24
011971
0186
2
1
4
3
0
5
6
9
5
4
20
29
36
15
21
31
14
11
88
0
105
133
237
132
2
14
5
38
113
117
.734
103
197
106
303
689
306
217
23
81
8
4765
9
98
05
944
8
10
1
2
2
21
48
142
285
238
357
203
178
9
67
272
35
3215
456
87222
20
76
359
97
310
8125
280
18
2553
1150
135
0520
231
352
99
07198
27
18
3438
20
122
254
177
8430
199
137
62
32
40
27
430
6251
1220
622
58
16
1
51
12
2
1-4
<1
08
4
22
62
239
15
353
399
102
572
634
127
513
100
4031
144
51
34
20
23
139
123
035
50
2903
790
326
212
134
241
23
14
19
41
385
402
27
352
176
32
164
579
45
331
119
52
7236
229
25
645
582
3677
104
194
234
28
536
17
282
318
65
82
296
24
14
1025
614
52
276
77
363
2617
514
42
476
2063 35-39 40-44 45-49 50-54
274
11
7206
107
5-9
25-29
30-34
55-59
60-64 65-69
75-7980-84
>=85 All
345
659
303
375
578
609
737
839
770
624
748
925
167
243
743
1247
1142
Table
E (Males
twelve70-74
months
1993/1994)
Inflicted by other (total)
1
020
0
3
1
13
6
01
6
147
5
8
9
2
0
1710
4
7
4
64
5316
450
63
8
9
8
01720
351286
18
39
38
17
207Non-motor
10
3
24
8
11
25
58
16
12
18
21
278
1
266
155
53
0
02411
15
12
22
17
220
1
013349
5
3
13
05122
48
20
29
11
879511
1310-14 15-19vehicle
4
2
18
17
1-4
12243
31
26
14
18
35
15
25
4
15
11
124
343
225
280
215
233
212
519
230
5681
21
27
24
17
14
4
8
<1 7 traffic (total)
001
262
601
943
5-9
20-2425-2930-3435-3940-44
Railway
TwelveAdmissions,
months, 1Females
July
1993 to 30 June 1994
rivate Hospital Injury
Victoria
45-4950-5455-59
60-64
TABLE
F
65-69
70-7475-79
80-84
>=85 All
~
10
61414
3548
116
65
10
60
18
19
51
614
26
115
131
360425-9
210
29
90
64
62
34
57
66
89
253
10
15
68
23
63
3473
079
232
121
400
57184
02
8177
9510
01
344
260
26
23
18
749
035
15
51
31
17
4038131
7630
9
455
75
33
217
9
14
42
4092310-14
092
55
13
125
5442
846
48
391
810
276
238
956
41
17627
0468
663
14
11
16
144
21
12970
14509
17
69
51
12
21642984
1-4
730
61
13
260985
55161
<1
15-1920-24
03
1
25-29 030-34
35-39 40-4445-49
Choki ng/suffocation/
/foreign body (total)
50-54
60-64 65-69
70-74
75-79 80-84
>=85 All
Table 55-59
F (Females
twelve
months
1993/1994)
877
1930
100
049
18
2023
7110
11
137
141
13
21
86
3128
26
27
25
113
112
1-4
35
134
2609
4106
101
109
41
117
1012
50
66
3766
0295
19694
97
08375
21
7515
111
0
0351Other
288
258
12
11
88
62
10
132
395-9
57
5413
0348
5086
544
6351
198
257
389
521
165
463
477
337
825
4177
means
138
104
108
12
105
102
31
122
1425
1376
64
75
55
67
77
82
70
58
50
53
2457
16
<1
0
31
218
112
2227
126
156
355
307
279
220
271
355
946
236
146
341
293
204
379
455
380
127
117
264
53
316
178
58
52
72
308
011
22
135
20
7338
3955
5974621
10
431
4441
234
405
5056
59
68
38
45
55
55819
232
214
289
603
354
458
317
509
4541
126
278
12
392
5391
226
53284
524
2
70 0219
177
496
1
658
374
477
671
663
528
876
551
987
641
898
1180
10875
Table F 60-6465-6970-7475-79
(Females twelve months 80-84
1993/1994)
10-14
15-1920-2425-2930-3435-3940-4445-4950-5455-59
>=85All
01 139
5
23
8
68
4
29
3
1
9
8
19
8
9
0
12
123
10
108
13
21
6
79
9
56
17
31
0
7
12
2
18
30
31
20
41
129
1
48
52
16
67
4
129
12
40
1
6
29
6
124
9
44
7Non-motor
4
110-14
27
11515
114
52
53
19
53
4
4
0
20
2
24
7
2
34513
1
314
345
6
13
2
162
136
17
11
8
025
1
5
63
74
8
7
0
9
878
01
0
16106
9
5
5
3
27
0
3
105
49
55
70
8
50
37
23
40
32
42
56
12
11
10
155
13
10681
1415
17
14
11
4
1
0
6
0
25
2
16
14
1
76
91
75
1811
123
10
3
15
27
37
495
681
881
927
120715-19
1300
1879
24159
92450-5455-5960-6465-6970-7475-7980-84
10
132
7
13
37
216
180
41
67
107
75
1656
150
102
174
115
32
25
70
120
89
2
0
1-4
<1
0
17
7
1
128
1012
149
931
1979
2584
24
2262
1857
1619
1393 40-44
1305 45-49
1033
vehicle
traffic
(total)
TABLE G
5-9
20-24
25-29
30-34
35-39
Railway
months,
1
January
1993
to
30
June
1994
vate HospitalEighteen
Injury Admissions,
Victoria
Total (Males and Females)
>=85 All
......•
2
4
14
1
3
94
2
115
80
174
13
138
132
42
6
13
164
198
68
34
57
188
36
6
5
3
5
5
102
3
37
36
0 1062 1617
39
46
55
58
118
12
20
16
16
21
5
18
1
9
5
1
194
406
19
10
15
7
9
29
12
296
25
87
41
391
51
6
0
246
1
1-4
0
0
21
14
18
26
3
238
76
63
168
197
4
498
387
268
8
136
18
30
24
11
124
10
205
127
121
75
49
73
22
0
126
124
11
23
70
20
0
86
2
27
32
0
93
456
51
4
750
111
47
69
66
59
74
91
551
374
151
44
40
8
31
58
7
7
10
8
18
15
23
185
6
6
12
17
9
3
378
243
395
423
291
338
278
238
289
17
15
5
32
242
63
386
43
24
140
31
6
0
76
325
1937
211
24
44
349
3
8
12
20
2
30
32
19
2
0
34
113
1243
311
711
138
52
7
666
244
4
22
50
1
1
19
90
25
5
14
15
163
539
198
265
29
98
4211
224
201
307
2407
109
95
447
109
28
6
1
19
25
12
15
9
76
272
350
442
557
414
0
10
25
26
9
7
29
28
4
3326
72
13
7
3
855
23186
1 2
1
27311
<1
3
0
4
888
8669
8
Table60~4
G (Total
months75-79
1993/1994)
5-9
10-1415-1920-2425-2930-3435-3940-4445-4950-54
55-59
65~91870-74
80-84 >=85 All
Choking/suffocation/
/foreign body (total)
61
134
3475
20
631
104
35703
685
23
63
3418Other
01
95110-14
106
967
6654
893
522449
0961
42857
5697
0975
73
56
1-4
82
81
15931
853
38
700
64
246
99
means
All
38
11670
62
26
23
59
29
16
18
103
10
103
9681
722
11
3246
5172
27
10
3168
225
8138
60
8490
26
21
33
90
16
23
9962
74
205
3256
376
50361
12
25
38
62
451
33
87128540
814
2904
88
8347
74
17
8652
223
148
182
278
863
354
9635
761
60
117
42
690
521
76
123
32130
2763
304
83
960
16
196
257
17
47
768
59
1298
82
14
409
195
1114
18
691
11
73
327
369
149
779
7696
25
12
16
47
113
10
34
15
44
216
1058
50
196
37
56
14
113
21
13482
16077
555
593
12
15
82
1319
1664
1690
1349
201
497
42
67
1192
272
10938
942
53
4525
414
870
881
977
891
668
1225
1502
1305
1501
1172
1885
24608
931
355
139
25
12
330
634
38
108
30
141
77
167
52
291
70
47
278
1025
1218
<1
1128
15
1172
024131686
1418
1731
1728
1374
104
4109
28
43
12
32
73
283640
50
0126
209
124
539
718
680
796
934
91
753
1040
119
797
12011
2032
2640
2300
1897
2530-34
10
1447
1343
1050
563
121
155
1276
827
549
1 3274
15
40
5-9
15-1920-2425-29
35-39
40-44
45-49
50-54
55-59
60-6465-6970-7475-79
80-84
1019
2387
3000
2750
2661
2472
2561
2178
2103
2309 182624
2670 2599
2132 >=85
2448
40539
Table
G (Total
months
1993/1994)
Inflicted by other (total)
0623
106
105
30645-9
53
8391
30
56
20
123
210
841
05337
21
102
39
22
90
35
6014
65
28
64
104
5513
212
75
67
10
12
294
13
14
114
63
34
27
46
29
11
15297
92
4745
320
14
46083
215
01
11
21
31245
12
605
349
279
0223
19
115
7127
84
941
13
29
119
122
198
22
1-4
18
2604326
122
19
4713
89
90
54
57
30
<1
12 traffic
0201
18
110-14
107
4442
616
13675
121
10
59
24
615
1441 15-19
1938
1720
1346 30-3435-3940-4445-4950-5455-5960-6465-69
1101
920
Non-motor
vehicle
(total)
8;2
20-24
25-29
Railway
rivate Hospital
Eighteen
Injury Admissions,
months, 1 January
Victoria
1993 to 30 June 1994
Males
TABLE
H
70-7475-79
80-84 >=85 All
0
8
613
28
31
69198
13
0221
901
125
10
106
1208
26
10
11
093710-14 15-19 <1
25
9113
835
5380
639
60
11
17
18
314
185
277
41
842
97
104
32
59
211
26
15
184
48
8Choking/suffocation/
40
17
24
102
144
10
2437
26
10
108
169
026447
85-9
20
22
3238
1311
65
7632
457
98
316
566
20
47
99
66
0244
24
75434
1346
0213
72
283
23
12
719
11
4133
16
148
183
29
14
53
1361
52
59
242
23
40
19
162
12
65387643336
350
52
29
589
95
50
117
148
353
93
74533
14
29
266
40
11
178
131
115
20
158
522
184
30
178
25
111
133
13
670
21
135
49
228
20
113
1427
145
59
142
12
49
15
17
287
298
37
084
51
124
318
1613
22
44
80
74
17
1-4
907
0
114
248
10
2301
20-24 25-29 130-34
35-39 40-44 45-49 50-54
55-59H (Males
60-6465-69
70-7475-7980-84
Table
18 months
1993/1994)>=85 All
/foreign body (total)
817
6436
2993
580
7648995
13
5447
04348
0363
452
31
105
215
1391
14
16
390
40178
69
169
148
373
27
59
73
6697
47
71
17
138
128
481
163
652
444
293
53
15
44
39
27
104
60
859
50
56
12
613
112
1132
021539
05
42
60
108
35
174
157
214
355
29
338
2349
882
83102
79
20
294
22
195
101
505
377
409
202
36
32
45
44
326
506
41
334
485
24
33
894
634
25
15
973
3875
7617
5695
628
87
220
11
499
781
194
150
730
539
389
555
644
704
113
524
5089
755644
21
29
80
406
565
92
387436
1-4
23
60
72
436
220
7199
31
78
37
119
10
285
20947
355
16
32
12
689301Other
42
535
221
167
629
6211
330
26
605
800
135
801
562
14
74
13
226
257
70
46
225
208
26
148
935
12112
32
44
59
518
328
446
304
13875
754
344
620
307
1476means
1968 <1
1739 1772
1363
13 30-3435-39
13
1121
10
00231 1269 40-4445-49
49
247
935
13
21492
596
26
655
1671
2345
1498
1364 1098 50-54
1123 55-59
1246
1328
1198
Table
H (Males
months
5-9
10-14
15-19
20-2425-29
60-64
65-69
70-74
75-791993/1994)
80-84 >=85 All
91918
Inflicted by other (total)
1
17
25
16
1
23
02
12
3
32
19
38
52
10
0
0290
2
3
2
20
3
30
40
65
9
61
108
3518
23
23
54
45
7643201110-14
4
95
020
9
9
11
45
7
43
316
2
18
28
27
29
36
15
626
1
39
38
6
53
21
22
28
473
410
27
42
53
92
62
7
53
15
101
1
7
4
4
27
2
0
6
7
23
18
12
11
10
413
14
33
29
19
13
1
201
18
89
59
8
4
8
542
65
24
933
31
428
464
532
511
436
35
518
24
105515-19
1553
10484
3646
0
5
1-4
Total
538
46
<1
TABLE
12 traffic
01
0 35-39 40-44 45-49 50-54 55-59 60-64 65-69
5-9
20-24
25-29 (total)
30-34
70-74 I 75-79 80-84 >=85
Non-motor
vehicle
Railway
ate HospitalEighteen
Injury Admissions,
months, 1 January
Victoria
1993
to
30
June
1994
Females
VJ
668
313
31
4121
23
55
018
25
60
40
42
46
52
56
62
199
6578
80
348
11
109
15
103
165
20
28
20110
519
73
247
15
70
38
28
59
235
137
26
12
105
18
116
1-4
22
725
115
62
25
71
8145
38239
832
11
14176
10
118
9851
14
133
41
10
82
292
80
145
250
107
119
129
24
17
49
134
114
65
5122
454
20
160
95
021
1737
1327
16
29
26
103
0187
89
72
16
00
100
23
4317
463
20336
29
703
83
426
21
23
510
4212598
13
15
3413
720336
10
711
27
818
0 0251
11
203534
110-14
63
9357
661
248
5333
441
80313
44
884
1340
Choking/suffocation/
5-9
15-19 <1
20-2425-2930-3435-3940-44
(foreign body (total)
Table 60-64
I (Females
months
1993/1994)
45-49 50-54 55-59
65-69 1870-74
75-79
80-84 >=85
Total
Cutting/piercing
115
O
ther
means
3230
10
889
13478
927
62024
49820265
0211
233
37
30
5895
6810
119
204
149
0720
5237
1483
82490110-14
43
219
716
929
364
888
19047
477
626
46
26
495
436
20
18
12
127
179
11
0147
130
138
282
13
21
12
29
163
22
15
18
16
8684
92
896
46
191
119
0
68
290
556
54
125
129
100
538
210
4129
484
205
437
182
188
225
38
12
10733
Total
13700
2565
0523
19
15
1327
2672
65
235
115
54
7501
40
29607
19
160
371
46
25
20
758
53
1043
618
106
691
598
978
1163
1203
1197
1296
1472
1680
1536
16
110
104
55-9
257
740
41
834
713
643
133
327
567
44
24142
8314
72
1-4
20
209
10
100
26016
427
124
361
610
627
555
192
27
6316
22
14
23
17
26
117
196
11
23
14
24
9471
219
241
151
203
230
318
940
638
445
512
534
413
1058
1557
108
2136
153
100
12
10
453
82
808
717
5291
607
340
558
35
39
840
7271
092
358
571
385
444
<1
0
279
507
214
11
259
561
2 1080
15-1920-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-6465-69
70-7475-7980-84
12980
00201 1063
14
Table
I 1942
(Females
18 months
1993/1994)>=85
5
1.1
1.7
77
991
17
47
45
1.6
116
1.6
1.5
1.4
231
35
20
1.0
3027
0.9
148
1.0
1590
2
1.12984
39
38
0
6mo
2852
672
1.75056
1.84541
515
0.7
0.9
1.1
21
22
55
6669
380
1.15819
81
89
80.7
509
105
122
16
88
374
304
1.15681
243
411
1993
1.8
68
13
14
312
1471
1425
128
108
75
184
0.2
1.3
1.7
40
23
2349
26
53
65
2180
2730
3258
528
Ratio
Ratio
12mo
0.7
1.3
1.4
1.3
1.1
1.4
1.3
1.4
7206
1411971
1.5
6571
1.2
210
19
1.4
1993/1994
328
7104
55
12:6
mo
1.5
1.7
86
0.9
137
1.0
1.0
2.0
1.8
0.0
0.1
1.3
1.3
23
59
Ratio
1.6
1.7
1.0
1.6
1.7
4765
4031
734
2.1
4914
1.2
43
166
103
1446
38
92
154
182
1.4
4803
1.4
1.1
567
0.9
2617
327
183
1.2
45
100
7
3939
1.2
1.2
1746
50
1
1.0
6110
11583
1371
63
143
67
30
1.3
9521
10875
12:6
441
678
54
mo
mo
978
129
196
449
4498
455
66
124
1 mo
4910
1200
1249
6mo
12
1955
210
Females
11374
12785
571
75
4042
332
4730
89
61
9821
13025
1.3
8172
1993
8572
1993/1994
1.3
17693
22846
Total
Choking/suffocation/foreign
body
Hit/struck/crush
Six
months,
1
January
1993
to
compared
30
June
1993
with
Twelve
months,
1
July
1993
to
30
June
1994
Private Hospital Injury Admissions, Victoria
Males
TABLE J
1639
1.9
0.1
14
5
866
Public
694
1.4
1.1
314
40
26
453
2.32387
2.4
2.2
8.6
5.4
1203
1807
3000
716
888
178
4059
1.12103
5.2
1296
1850
980
624
1810
2055
1472
1198
767
0.6
1498
2.4
2.5
8.8
6.1
6.6
7.4
5.9
1080
1775
1544
4
066
863
472
661
2345
2112
1671
1269
2541
2562
3280
1770
1.0
4.7
5.4
6.5
5.7
1063
2
660
309
1246
1328
1040
0.8
670
219
1563
762
330
2199
5.7
1680
2364
862
599
2.5
1.81019
2.1
2.0
1.4
1.7
4.5
6.0
5.1
7.2
3.6
6.3
8.1
1197
1163
364
1030
2
4105
1584
1294
6
3835
3274
439
929
459
008
561
1498
1364
1098
655
4233
1492
Males
Females
Total
1.2
1.3
4.8
3.9
1536
5.3
2250
1446
2668
3
221
290
132
1123
1775
738
M
%
ales
Females
M:F M:F
1.5
1.4
5.5
549
0.5
6.4
919
1.82750
1.1
5.6
1109
1426
978
1772
2033
1409
0.4
1147
%
596
1521
753
1.3
1.9
1.5
763
3.8
6.8
2602
0.3
327
1490
436
2248
2245
29588
6.0
998
67902
40539
100.021492
100.0
1.3
19047
38313
0.32448
4.4
1942
506
1.1
Injury1 Jan
Admissions,
Jul1987
30
Jun
1993
l Public
compared
with
al
Injury Hospital
Admissions,
1993 - 30 1Jun
1994,
Victoria
by age
group
Private
TABLE K
.. 66 ..
11"
11.I;l.lIlll
106
1.9
737
113
889
133
0.3
941
60
39
8.4
639
9190
298
3336
92
61
3.0
15.5
1.4
31.1
1.2
34
2.6
6
5.8
118
497
0.5
2437
2280
2088
1652
17567
10484
13675
0.3
841
436
292
223
186
488
165
105
132
0.6
0.8
25
2.6
90
715
0.4
2.8
828
35
11.3
38
559
99
1.6
10.6
1.7
15.8
63.6
4.9
2.9
65.6
3.4
7.9
59.4
7.1
5.6
7.7
3014
4079
641
11928249
3219
6041
1885
1129
616
2896
0.0
5644
10733
1080
0.4
265
6211
808
0.1
5333
367
65
26.3
24.0
27
45
20.2
31.7
3.1
931
1.8
4.7
73.7
3.6
2
2219
7734
9183
1002
1008
1792
676
73 Total
Private
Public
1406
8314
2.3
33.2
1.5
6.5
26.3
1234
0.6
1.8
Total
3254
0.2
453
211
4.4
2781
2321
0.2
4047
11.0
1104
0.3
%
0.9
2.5
62.9
3.4
3.2
9.4
25116
1321
13875
19754
7271
9384
28.9
2.7
3027
0.0
1094
64.6
1042
66.8
28.0
0.2
21.4
0.4
2.2
0.8
24.9
4.5
4.0
1.6
1.5
1043
7617
451
9835
35.4
10065
882
Total
5102
246
2163
2.4
4.7
0.2
3.8
1.0
1.1
218
1.2
55.0
0.6
1.1
13.7
1.3
7.5
4.1
6.0
59.6
8.2
%
0.0
325
0.3
0.1
2087
155
106
16923
15.2
2723
1.4
21.1
8
27.3
33.3
60.7
3.1
1333
5.5
29.3
Private
224
3326
24159
9294
1656
129
6359
515
130
42683
73
773
21492
19047
%
38313
8540
904
24608
48003
8669
18567
38.2
56.4
106
70.7
19899
43.6
2.0
39.3
Total
1012
376
%
29588
100.0
13482
Females
2449
15931
Private
Public
100.0
100.0
67902
Natural/environmental
40539
Choking/suffocation/foreign
body
HospitalInjuryAdmissions,
Jul1987
compared
-30
Jun
with
1993
alPublic
InjuryAdmissions,
1 Jan 1993 - 30 1Jun
1994,
Victoria
by injury group
Males
TABLE
L