The Ecological Fallacy of the Role of Age in Chronic Disease and Hospital Demand

Abstract

Supplemental Digital Content is available in the text.

Hospital use in Aboriginal and non‐Aboriginal patients with chronic disease

“…4,5,17 The differences observed were lower than those observed here 4 and sometimes restricted to individuals living in regional areas 5 or in younger cohorts. 11 Aboriginal people have higher rates of chronic disease than non-Aboriginal people, such that mean rates of hospital use across the entire cohort of Aboriginal people may not accurately reflect use in this key group compared to non-Aboriginal patients with chronic disease. Such studies are susceptible to the ecological fallacy, in that what is true on average for the group is not necessarily true for individuals or sub-groups within that group.…”

“…11,15 In interpreting the results, it must be noted that older patients had higher mortality rates than younger patients following the cardinal event. Patients who died in the period following the cardinal event were left in the analysis, as the net hospital demand associated with all cardinal events was being examined, not the hospital use of surviving patients.…”

“…However, because of the ecological fallacy, 11 generalisations from the entire cohorts of Aboriginal versus non-Aboriginal patients (with differing rates of chronic disease) do not allow this comparison to be made. However, because of the ecological fallacy, 11 generalisations from the entire cohorts of Aboriginal versus non-Aboriginal patients (with differing rates of chronic disease) do not allow this comparison to be made.…”

Australasian specialist emergency medicine workforce: Here and now … and beyond

“…High utilisation rates by those aged 75+ years, coupled with an ageing population, will likely result in further significant rises in demand by 2025. Chronic disease rates in both young and old are also rising, with associated increases in ED utilisation …”

“…Chronic disease rates in both young and old are also rising, with associated increases in ED utilisation. 14…”