The nature of increased hospital use in poor neighbourhoods: findings from a Canadian inner city.
The relationship between socioeconomic factors and hospital use is not well understood in the Canadian context. We used the 1991 Canada census and 1990-92 Ontario hospital discharge abstracts for residents of southeast Toronto to calculate crude and age-sex adjusted rates of hospital admission, bed days, and costs by quintile of low-income households. Population-based rates of admission to hospital, bed days and costs were all significantly related to census tract income (p < 0.01 for males and females). The number of admissions per person admitted was significantly associated with census tract income (p < 0.01 for males and females), but length of stay and resource intensity weight were not. Hospital costs were 50.0% higher for the poorest quintile of neighbourhoods than for the wealthiest and 35.8% higher than for the middle-income quintile. Poor urban neighbourhoods may require more resources than previously anticipated, related to higher hospital admission and readmission rates.
Glazier
R H
RH
Department of Family and Community Medicine, University of Toronto, Ontario. glazierr@smh.toronto.on.ca
Badley
E M
EM
Gilbert
J E
JE
Rothman
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011204:Poverty Areas; D012044:Regression Analysis; D012923:Social Class; D014600:Utilization Review