Kamis, 17 Oktober 2013

The Odds of Going to the Hospital

What are the odds that you will need serious medical care?

By "serious medical care", most people will automatically think of a situation where they might need to be admitted to a hospital to receive care for an unforeseen condition, so that's the standard we'll use to answer that question.

Beyond that, we'll break the information down by age and sex, simply because we can see these being major factors that might affect how likely a person will need hospital care.

It turns out to be a really difficult question to answer, because in the U.S., which is where we first sought to get hospital utilization data, tracks hospital discharges - not admissions. The problem with that is that the number of admissions won't necessarily track with the number of discharges, as patients die or perhaps otherwise leave the hospital before being officially discharged.

So we turned elsewhere to answer the question, and specifically to the island nation of Singapore, whose Ministry of Health makes the data not only easy to find, but presents it in a way that helps us answer our specific questions. Our first chart below illustrates the 2011 hospital admission rates by age group and sex per each 1,000 members of Singapore's resident population:

Singapore: 2011 Number of Hospital Admissions per 1,000 Population, (Excludes Normal Deliveries and Legalized Abortions)

One interesting aspect of the data is that we see such high numbers for the 0-4 age group, which drops off dramatically for the 5-9 age group, which really didn't make a whole lot of sense to us at first. Why would a 4-year old have such a dramatically higher probability of being admitted to a hospital over a 5-year old?

We started thinking about it, and realized that the MOH's statisticians gave us a valuable clue - the number of hospital admissions for each 1,000 members of Singapore's resident population doesn't include hospitalizations associated with either normal deliveries for pregnancy or legalized abortions.

While both of these categories would count as foreseeable conditions, we suspect that the reason in the case of normal deliveries was in part to avoid double-counting. Here, where normal deliveries are concerned, we suspect that infants born in Singapore's hospitals are subsequently "admitted" to the hospital after being born, which is how the hospital admissions associated with normal deliveries are tracked.

Beyond that, we can see that the rate of hospital admissions for women of child-bearing age is over twice that of men of the same age, which likely corresponds to pregnancies that involved complicating factors requiring more intensive care, which would not count as a foreseeable condition.

Having worked out why that apparent anomaly exists, we used that knowledge to determine the probability of being admitted to a hospital for both men and women by age, reverse engineering Singapore's age-group based data to approximate the odds by single year of age from Age 0 through Age 84:

Probability of Hospital Admission for Men by Age (Singapore 2011)

Note how nearly 100% of those 0-year olds are admitted to the hospital! Next, let's look at the same data for women from Age 0 to Age 84:

Probability of Hospital Admission for Women by Age (Singapore 2011)

In looking at the differences in the data between men and women, we see that boys are more likely to be admitted to a hospital before Age 4, after which we see that both boys and girls have similar odds up until child-bearing becomes a factor. At that point, women are much more likely to require hospital admission than men (likely for the reasons we noted earlier), up until their mid-forties, after which, men become much more likely to require hospital admission.

The longer lifespan of women with respect to men likely explains that discrepancy, although we were surprised to see how wide that gap was by Age 84, with women having a 50% probability of being admitted to a hospital and men having almost a 90% probability.


Singapore Ministry of Health. Hospital Admission Rates* by Age and Sex 2011. [Online Report]. 10 November 2012. Accessed 8 October 2013.

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