Trends in alcohol-attributable hospitalisation in the Northern Territory, 1998-99 to 2008-09.

OBJECTIVE: To examine trends in hospitalisation for alcohol-attributable conditions in the Northern Territory Aboriginal and non-Aboriginal populations between the financial years 1998-99 and 2008-09. DESIGN AND SETTING: Retrospective descriptive analysis of inpatient discharge data from NT public hospitals. MAIN OUTCOME MEASURES: Alcohol-attributable hospitalisation by age, sex, Aboriginality, region of residence and medical conditions, with annual time trends. RESULTS: Annual rates of hospitalisation for alcohol-attributable conditions across the NT increased from 291.3 per 10,000 population to 460.0 per 10,000 (57.9%) among Aboriginal males and from 181.8 per 10,000 to 387.4 per 10,000 (113.1%) among Aboriginal females over the study period. The alcohol-attributable hospitalisation rate also increased from 58.8 per 10,000 population to 87.4 per 10,000 (48.6%) among non-Aboriginal males and from 16.8 per 10,000 to 37.2 per 10,000 (121.4%) among non-Aboriginal females. Alcohol-attributable hospitalisation rates among Aboriginal people living in Central Australia were much higher than in the Top End. In Central Australia, the rates for Aboriginal females increased throughout the study period, but for Aboriginal males declined from 2004-05 onwards. CONCLUSION: Rates of hospitalisation for alcohol-attributable conditions were high among NT Aboriginal people and increased during the study period. Although not statistically significant, the moderation in rates among Central Australian Aboriginal males after 2004-05 is encouraging. This apparent improvement is consistent with another recent study and provides tentative support that recent policy changes and interventions may be having an impact. The results of this study highlight the burden of alcohol use in the NT and emphasise the need for ongoing investment in comprehensive alcohol-management programs.

Trend analysis of hospital admissions attributable to tobacco smoking, Northern Territory Aboriginal and non-Aboriginal populations, 1998 to 2009.

BACKGROUND: Tobacco smoking is a well-recognised risk factor for many diseases [1]. This study assesses the extent of smoking-attributable hospitalisation in the Northern Territory (NT) Aboriginal and non-Aboriginal populations, and examines smoking-attributable hospitalisation trends for the years 1998/99 to 2008/09. METHODS: Hospital discharge data were used for the analysis. The proportion of conditions attributable to tobacco smoking was calculated using the aetiological fraction method. Age-adjusted smoking-attributable hospitalisation rates were calculated to describe the impact of tobacco smoking on the health of Territorians. A negative binominal regression model was applied to examine trends in smoking-attributable hospitalisations. RESULTS: Aboriginal Territorians were found to have higher rates of smoking-attributable hospitalisation, with Aboriginal males more than three times and Aboriginal females more than four times more likely to be hospitalised for smoking-attributable conditions than their non-Aboriginal counterparts. The age-adjusted hospitalisation rate for Aboriginal males increased by 31% and for Aboriginal females by 18% during the study period. There were more modest increases for NT non-Aboriginal males and females (5% and 17% respectively). The increase among Aboriginal males occurred up until 2005/06 followed by moderation in the trend. There were small reductions in smoking-attributable hospitalisation rates among all populations in younger age groups (less than 25 years). CONCLUSIONS: Aboriginal Territorians experience much higher smoking-attributable hospitalisation rates than non-Aboriginal Territorians. The scale of the smoking burden and suggestion of recent moderation among Aboriginal men reinforce the importance of tobacco control interventions that are designed to meet the needs of the NT's diverse population groups. Preventing smoking and increasing smoking cessation rates remain priorities for public health interventions in the NT.

Avoidable hospitalisation in Aboriginal and non-Aboriginal people in the Northern Territory.

OBJECTIVES: To analyse rates of avoidable hospitalisations in Aboriginal and non-Aboriginal residents of the Northern Territory, 1998-99 to 2005-06, and to consider the implications for primary care interventions. DESIGN AND SETTING: Retrospective descriptive analysis of inpatient discharge data from NT public hospitals. MAIN OUTCOME MEASURES: Avoidable hospitalisations by age, sex, Aboriginality and condition, with annual time trends. RESULTS: Between 1998-99 and 2005-06, Aboriginal people in the NT had an avoidable hospitalisation rate of 11 090 per 100 000 population, nearly four times higher than the Australian rate of 2848 per 100 000. The rate for non-Aboriginal NT residents was 2779 per 100 000. During this period, the average annual increase in avoidable hospitalisations was 11.6% (95% CI, 11.0%-12.1%) in the NT Aboriginal population and 3.9% (95% CI, 3.3%-4.5%) in the non-Aboriginal population. The greatest increase occurred in those aged > or = 45 years, and was primarily attributable to diabetes complications. CONCLUSIONS: The significantly higher rates of avoidable hospitalisations in NT Aboriginal people reflect the emerging epidemic of chronic disease in this population, highlight barriers to Aboriginal people accessing effective primary care, and emphasise the extent of potential health gains with appropriate interventions.