title: Use of acute care hospital services by immigrant seniors in Ontario: A linkage study.
abstract: BACKGROUND
  Seniors constitute the largest group of hospital users. The increasing share of immigrants in Canada's senior population can affect the demand for hospital care.
  
  
  METHODS
  This study used the linked 2006 Census-Hospital Discharge Abstract Database to examine hospitalization during the 2004-to-2006 period, by immigrant status, of Ontario seniors living in the community. Hospitalization was assessed with logistic regressions; cumulative length of stay, with zero-truncated negative binomial regressions. All-cause hospitalization and hospitalizations specific to circulatory and digestive diseases were examined.
  
  
  RESULTS
  Immigrant seniors had significantly low age-/sex-adjusted odds of hospitalization, compared with Canadian-born seniors (OR = 0.81). The odds varied from 0.4 among East Asians to 0.89 among Europeans, and rose with length of time since arrival from 0.54 for recent (1994 to 2003) to 0.86 for long-term (before 1984) immigrants. Adjustment for demographic and socio-economic characteristics did not change the overall patterns. Immigrants' cumulated length of hospital stay tended to be shorter than or similar to that of Canadian-born seniors.
  
  
  CONCLUSIONS
  Immigrant seniors, especially recent arrivals, had lower odds of hospitalization and similar time in hospital, compared with Canadian-born seniors. These patterns likely reflect differences in health status. Variations by world region and disease reflect the diverse health care needs of immigrant seniors.
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Edward
authors.initials: E
authors.lastname: Ng
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sanmartin
authors.affiliation: the Institute for Clinical Evaluative Sciences and the University of Toronto.
authors.forename: Jack
authors.initials: J
authors.lastname: Tu
authors.affiliation: Health Analysis Division, Statistics Canada, and the University of Ottawa.
authors.forename: Doug
authors.initials: D
authors.lastname: Manuel
mesh_terms: D000367:Age Factors; D000368:Aged; D019352:Censuses; D016208:Databases, Factual / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008498:Medical Record Linkage; D009864:Ontario / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Aging; census; databases; health services; hospitalization; length of stay; medical record linkage