title: Relationships of multimorbidity and income with hospital admissions in 3 health care systems.
abstract: Associations of multimorbidity and income with hospital admission were investigated in population samples from 3 widely differing health care systems: Scotland (n = 36,921), China (n = 162,464), and Hong Kong (n = 29,187). Multimorbidity increased odds of admissions in all 3 settings. In Scotland, poorer people were more likely to be admitted (adjusted odds ratio [aOR] = 1.62; 95% CI, 1.41-1.86 for the lowest income group vs the highest), whereas China showed the opposite (aOR = 0.58; 95% CI, 0.56-0.60). In Hong Kong, poorer people were more likely to be admitted to public hospitals (aOR = 1.68; 95% CI, 1.36-2.07), but less likely to be admitted to private ones (aOR = 0.18; 95% CI, 0.13-0.25). Strategies to improve equitable health care should consider the impact of socioeconomic deprivation on the use of health care resources, particularly among populations with prevalent multimorbidity.
authors.affiliation: JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Harry H X
authors.initials: HH
authors.lastname: Wang
authors.affiliation: School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
authors.forename: Jia Ji
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Centre for Research Excellence in the Prevention of Chronic Conditions in Rural & Remote Populations, James Cook University, Cairns, Queensland, Australia.
authors.forename: Kenny D
authors.initials: KD
authors.lastname: Lawson
authors.affiliation: JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
authors.forename: Samuel Y S
authors.initials: SY
authors.lastname: Wong
authors.affiliation: JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
authors.forename: Fang Jian
authors.initials: FJ
authors.lastname: Li
authors.affiliation: School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
authors.forename: Pei Xi
authors.initials: PX
authors.lastname: Wang
authors.affiliation: School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
authors.forename: Zhi Heng
authors.initials: ZH
authors.lastname: Zhou
authors.affiliation: School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
authors.forename: Chun Yan
authors.initials: CY
authors.lastname: Zhu
authors.affiliation: General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Yao Qun
authors.initials: YQ
authors.lastname: Yeong
authors.affiliation: JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
authors.forename: Sian M
authors.initials: SM
authors.lastname: Griffiths
authors.affiliation: General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom Stewart.Mercer@glasgow.ac.uk.
authors.forename: Stewart W
authors.initials: SW
authors.lastname: Mercer
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006723:Hong Kong; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012606:Scotland; D012959:Socioeconomic Factors; D013222:State Medicine / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: chronic disease; cross-country analysis; health care system; hospital admission; multimorbidity; population-based study; socioeconomic factors