Public Health
Volume 161, 2018, Pages 5-11

Differences in all-cause hospitalisation by ethnic group: a data linkage cohort study of 4.62 million people in Scotland, 2001–2013 (Article) (Open Access)

Gruer L.D.* , Millard A.D. , Williams L.J. , Bhopal R.S. , Katikireddi S.V. , Cézard G.I. , Buchanan D. , Douglas A.F. , Steiner M.F.C. , Sheikh A.
  • a Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
  • b Public Health Science Directorate, NHS Health Scotland, Glasgow, United Kingdom
  • c Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
  • d Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
  • e MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
  • f Population and Health Research Group, University of St Andrews, United Kingdom
  • g Information Services Division, NHS National Services Scotland, United Kingdom
  • h Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom
  • i Department of Child Health, University of Aberdeen, United Kingdom
  • j Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom

Abstract

Objectives: Immigration into Europe has raised contrasting concerns about increased pressure on health services and equitable provision of health care to immigrants or ethnic minorities. Our objective was to find out if there were important differences in hospital use between the main ethnic groups in Scotland. Study design: A census-based data linkage cohort study. Methods: We anonymously linked Scotland's Census 2001 records for 4.62 million people, including their ethnic group, to National Health Service general hospitalisation records for 2001–2013. We used Poisson regression to calculate hospitalisation rate ratios (RRs) in 14 ethnic groups, presented as percentages of the White Scottish reference group (RR = 100), for males and females separately. We adjusted for age and socio-economic status and compared those born in the United Kingdom or the Republic of Ireland (UK/RoI) with elsewhere. We calculated mean lengths of hospital stay. Results: 9.79 million hospital admissions were analysed. Compared with the White Scottish, unadjusted RRs for both males and females in most groups were about 50–90, e.g. Chinese males 49 (95% confidence interval [CI] = 45–53) and Indian females 76 (95% CI 71–81). The exceptions were White Irish, males 120 (95% CI 117–124) and females 115 (95% CI 112–119) and Caribbean females, 103 (95% CI 85–126). Adjusting for age increased the RRs for most groups towards or above the reference. Socio-economic status had little effect. In many groups, those born outside the UK/RoI had lower admission rates. Unadjusted mean lengths of stay were substantially lower in most ethnic minorities. Conclusions: Use of hospital beds in Scotland by most ethnic minorities was lower than by the White Scottish majority, largely explained by their younger average age. Other countries should use similar methods to assess their own experience. © 2018 The Author(s)

Author Keywords

Data linkage cohort Scotland Hospitalisation Ethnic groups

Index Keywords

hospital admission Pakistani Chinese hospitalization health care policy information retrieval Indian human sex difference middle aged birthplace Cohort Studies Ethnic Groups statistics and numerical data ethnic group Aged socioeconomic status African length of stay national health service Confidence interval Young Adult Irish (citizen) social status Humans ethnic difference Ireland Adolescent male female population research health services Caribbean Article health care major clinical study adult Scotland age United Kingdom Censuses Information Storage and Retrieval cohort analysis Bangladeshi ethnicity immigrant population
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047600893&doi=10.1016%2fj.puhe.2018.04.010&partnerID=40&md5=179d35a0f9477eb3efc95ba2a20e0794
DOI: 10.1016/j.puhe.2018.04.010
ISSN: 00333506
Cited by: 1
Original Language: English