3. Tables 5.17 and 5.18 contain information on outpatient department visits in the populations served by two large regional hospital networks, Hancock Regional Hospital Network and Harrison Hospital System a. Determine the crude and age-adjusted rates of visits to the outpatient department in the populations served by Hancock Regional Hospital Network and Harrison Hospital System by filling in Tables 5.17 and 5.18. Table 5.17. Crude Rates for Outpatient Visits, Hancock Regional Hospital Network Age Population Number of Visits Crude Rates (per 1,000) Less than 15 44,995 9,224 15-24 27,469 5,329 2544 67,845 12,280 45-64 41.650 8,330 65-74 16,400 3,772 75 and older 11,147 3,099 Totals 209,506 42,034 Table 5.18. Crude Rates for Outpatient Visits, Harrison Hospital System Crude Rates (per 1,000) Age Less than 15 15-24 25-44 45-64 65-74 75 and older Totals Population 27,569 17.291 41,403 25,194 10.185 77.165 198,807 Number of Visits 6,148 5,222 10,682 7,130 3,137 2,423 34,742 b. Determine the ratio of the crude and age-specific rates of the population served by Hancock Regional Hospital Network and Harrison Hospital system. c. The data presented in Tables 5.19 and 5.20 indicate that the population distributions in the populations served by Hancock Regional Hospital Network and Harrison Hospital System are different. Calculate the percentage of the population in each age group in both populations. Table 5.19. Population Distribution, Hancock Regional Hospital Network Percent Age Less than 15 15-24 2544 45-64 65-74 75 and older Totals Population 44,995 27.469 67,845 41.650 16,400 11,147 209,506 Table 5.20. Population Distribution, Harrison Hospital System Age Population Percent Less than 15 27,569 15-24 17,291 25-44 41,403 45-64 25,194 65-74 10.185 75 and older 77.165 Totals 198,807 d. Before single summary rates between the populations served by Hancock Regional Hospital Network and Harrison Hospital System can be compared, outpatient visit rates must be adjusted to account for differences in age distribution. The first step is to select a standard population and its outpatient department visit rates. The standard population selected is the 2000 U.S. population (see Table 5.21). Age Group U.S. Population, 2000 Under 15 years 15-24 years 25-44 years 45-64 years 65-74 years 60,253,375 39,183,891 85,038,251 61,954,638 18,390,986 16,600,765 75 years and older Totals 281,421,906 The next step in direct adjustment of rates is to calculate the expected number of outpatient department visits in each age group. This is accomplished by multiplying the number of persons in each age category in the standard population (2000 U.S.) by the rates of outpatient department visits in each age category in the study populations (the populations served by Hancock Regional Hospital Network and Harrison Hospital System) e. See Tables 5.22 and 5.23. Calculate the age-adjusted outpatient department visit rates for the populations served by Hancock Regional Hospital Network and Harrison Hospital System by dividing the sum of the expected outpatient department visits by the total standard population. Table 5.22. Age-Specific Rate and Expected Cases for Hancock Hospital System Age (in Population Age Expected years) (U.S. 2000) specific Cases Rate Less than 15 60,253,375 15-24 39,183,891 25-44 85,038,251 45-64 61,954,638 65-74 18,390,986 75 and older 16,600,765 Totals 281,421,906 Table 5.23. Age-Specific Rate and Expected Cases for Harrison Hospital System Age (in Population Age-Specific Expected years) (U.S. 2000) Rate Cases Less than 15 15-24 25-44 45-64 65-74 75 and older 60,253,375 39,183,891 85,038,251 61,954,638 18,390,986 16,600,765 Totals 281,421,906 70,928,757 f. What is the ratio of the age-adjusted outpatient department visit rate in the population served by Hancock Regional Hospital Network to the age-adjusted outpatient department visit rate in the population served by Harrison Hospital System? 8. Describe the difference between the ratios crude and age-adjusted outpatient department visit rates