Summary

We investigated the association between hip fracture incidence and living area characteristics in France. The spatial distribution of hip fracture incidence was heterogeneous and there was a significant relationship between social deprivation, urbanization, health access, and hip fracture risk.

Introduction

Several studies have shown great disparities in spatial repartition of hip fractures (HF). The aim of the study was to analyze the association between HF incidence and characteristics of the living area.

Methods

All patients aged 50 or older, living in France, who were hospitalized for HF between 2012 and 2014 were included, using the French national hospital discharge database. Standardized incidence ratio (SIR) was calculated for each spatial unit and adjusted on age and sex. An ecological regression was performed to analyze the association between HF standardized incidence and ecological variables. We adjusted the model for neighborhood spatial structure. We used three variables to characterize the living areas: a deprivation index (French-EDI); healthcare access (French standardized index); land use (percentage of artificialized surfaces).

Results

A total of 236,328 HF were recorded in the French hospital national database, leading to an annual HF incidence of 333/100,000. The spatial analysis revealed geographical variations of HF incidence with SIR varying from 0.67 (0.52; 0.85) to 1.45 (1.23; 1.70). There was a significant association between HF incidence rates and (1) French-EDI (trend p = 0.0023); (2) general practitioner and nurse accessibility (trend p = 0.0232 and p = 0.0129, respectively); (3) percentage of artificialized surfaces (p < 0.0001).

Conclusion

The characteristics of the living area are associated with significant differences in the risk of hip fracture of older people.

中文翻译：

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髋部骨折和生活区特征：法国的精细空间分析

概要

我们调查了法国髋部骨折发生率与居住区特征之间的关系。髋部骨折发生率的空间分布是不均一的，社会剥夺，城市化，健康状况和髋部骨折风险之间存在显着的关系。

介绍

多项研究表明，髋部骨折（HF）在空间分配方面存在巨大差异。该研究的目的是分析房颤发病率与居住区特征之间的联系。

方法

使用法国国家医院出院数据库，纳入了2012年至2014年之间居住在法国的所有50岁或以上居住在法国的HF患者。计算每个空间单位的标准化发病率（SIR），并根据年龄和性别进行调整。进行了生态回归分析HF标准发病率和生态变量之间的关联。我们针对邻域空间结构调整了模型。我们使用三个变量来表征生活区域：贫困指数（French-EDI）；医疗服务（法国标准化指数）；土地利用（人造表面的百分比）。

结果

在法国医院国家数据库中总共记录了236,328 HF，导致每年HF发生率为333 / 100,000。空间分析显示，HF发生率的地理变化具有SIR，从0.67（0.52; 0.85）到1.45（1.23; 1.70）。HF的发生率与（1）French-EDI（趋势p  = 0.0023）之间存在显着关联。（2）全科医生和护士的可及性（趋势分别为p  = 0.0232和p  = 0.0129）；（3）人造表面的百分比（p  <0.0001）。

结论

生活区的特征与老年人髋部骨折风险的显着差异有关。