Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7 : Australian orthopaedic association national joint replacement registry

Background The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia.Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006&ndash;7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk.Results Females accounted for 46.9% of the 642 primary THR performed during 2006&ndash;7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70&ndash;79&thinsp;years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups.Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA. <br /

\u27I get by with a little help from my friends\u27 : adults with intellectual disability discuss loneliness

Background This study explored \u27loneliness\u27 as experienced by adults with intellectual disability, with \u27intermittent\u27 to \u27limited\u27 support needs.Method A measure of loneliness was piloted, and qualitative techniques used to develop a greater understanding of the participants\u27 experience.Results The Loneliness Scale proved valid and reliable and the participants reported loneliness in ways comparable with the general population.Conclusions The findings demonstrate the effectiveness of combining quantitative and qualitative techniques to enhance understanding of people\u27s perspective when developing support systems to promote their quality of life. Based on participant perspectives, recommendations are made concerning the issues and types of support families and professionals could consider when seeking to assist people with intellectual disability address loneliness. Further investigation of the effects of differing educational and vocational opportunities on people\u27s post-school social networks appears warranted.<br /