As the populations ages rapidly, injury in older people is increasingly becoming a major health problem. This thesis examines the epidemiology of common injuries in older people and how data linkage can improve injury surveillance as well as knowledge about the circumstances and outcomes of injury in older people. These issues are explored using data from New South Wales, Australia and the emphasis is on injuries resulting from falls and traffic crashes as the most common mechanisms of injury in older people. The epidemiology and trends of hospitalisations as a result of hip, pelvic and wrist fractures are examined using NSW hospitalisation data during the 1990's. Internal data linkage of the 2000-2001 NSW hospitalisation data is used to eliminate double counting of hospital admissions for injurious falls in older people and to assess the validity and estimate the effects of previously used approaches on the incidence of hospitalised falls. Probabilistic data linkage of hospital and police crash records for the same year is also used to examine data quality in both collections and to explore the relationship between the circumstances and outcomes of injury in older drivers injured in a traffic crash. The findings of the epidemiological profile of hip, pelvic and wrist fractures in older people indicate that they are likely to continue to impose a considerable burden on acute health care services. The internal linkage of hospital data shows that data linkage techniques allow the identification of incident cases of hospitalised falls and point to the low validity of previously used approaches to estimate the incidence of these cases. Record linkage of hospital and police records demonstrates the limitations of using the datasets separately to examine the burden of traffic injuries in older people and shows the importance of environmental factors, complex road intersections in particular, in high injury severity in older drivers. The thesis also discusses some of the challenges of using record linkage for injury research and highlights the importance of including the date of injury and a unique personal identifier to improve the surveillance and reporting of injuries, including those in older people.
| Identifer | oai:union.ndltd.org:ADTP/215387 |
| Date | January 2006 |
| Creators | Boufous, Soufiane, Public Health & Communtiy Medicine, UNSW |
| Publisher | Awarded by:University of New South Wales. Public Health and Communtiy Medicine |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright Soufiane Boufous, http://unsworks.unsw.edu.au/copyright |
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