title: Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong.
abstract: Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rates by stroke subtype among the population aged 35 years and above in 1999-2007. Multilevel models were used to examine the spatio-temporal variations. Ischemic stroke incidence was found to decrease among those aged above 55 years, while hemorrhagic stroke incidence increased. Ischemic stroke case-fatality was found to decrease but hemorrhagic stroke case-fatality remained stable. For both subtypes, there were significant variations in stroke incidence and case-fatality across the districts of residence, but insignificant variations across HA service clusters. Only variations in ischemic stroke incidence and hemorrhagic stroke case-fatality at the district level could be partly explained by district-level SES. Identification of districts with higher risk for stroke incidence and case-fatality would help to formulate enhanced preventive measures. Future studies are needed to identify factors that contribute to the geographical variations.
authors: Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, People's Republic of China. phchau@graduate.hku.hk
authors: Pui Hing
authors: PH
authors: Chau
authors: Jean
authors: J
authors: Woo
authors: William B
authors: WB
authors: Goggins
authors: Moses
authors: M
authors: Wong
authors: Kam Che
authors: KC
authors: Chan
authors: Suzanne C
authors: SC
authors: Ho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005843:Geography; D054625:Healthcare Disparities; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D020521:Stroke / Q000145:classification / Q000453:epidemiology* / Q000401:mortality