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

Gruer, L.D., Millard, A.D., Williams, L.J., Bhopal, R.S., Katikireddi, S.V. , Cezard, G.I., Buchanan, D., Douglas, A.F., Steiner, M.F.C. and Sheikh, A. (2018) Differences in all-cause hospitalisation by ethnic group: a data linkage cohort study of 4.62 million people in Scotland, 2001–2013. Public Health, 161, pp. 5-11. (doi:10.1016/j.puhe.2018.04.010) (PMID:29852341) (PMCID:PMC6085114)

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Abstract

Background: Immigration into Europe has raised contrasting concerns about increased pressure on health services and equitable provision of healthcare to immigrants /ethnic minorities. We assessed hospital use by ethnic group in Scotland. 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: 9,789,975 hospital admissions were analysed. Compared to the White Scottish, unadjusted RRs for both males and females in most groups were about 50-90, e.g. Chinese males 49 (95% CI 45-53) and Indian females 76 (71-81). The exceptions were White Irish males, 120 (117-124) and females 115 (112-119) and Caribbean females, 103 (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 experiences.

Item Type:Articles
Additional Information:The authors thank the Chief Scientist Office for a grant (CZH/4/648) and NHS Health Scotland for a supplementary grant (no number). SVK acknowledges funding from the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). AS is supported by the Farr Institute.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Dr Vittal and Millard, Dr Andrew and Gruer, Dr Lawrence
Authors: Gruer, L.D., Millard, A.D., Williams, L.J., Bhopal, R.S., Katikireddi, S.V., Cezard, G.I., Buchanan, D., Douglas, A.F., Steiner, M.F.C., and Sheikh, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Public Health
Publisher:Elsevier
ISSN:0033-3506
ISSN (Online):1476-5616
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Public Health 161:5-11
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
699162Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiChief Scientist office (CSO)SCAF/15/02IHW - MRC/CSO SPHU
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU