title: Risk of respiratory hospitalization and death, readmission and subsequent mortality: scottish health and ethnicity linkage study.
abstract: BACKGROUND
  Limited and dated evidence shows ethnic inequalities in health status and health care in respiratory diseases.
  
  
  METHODS
  This retrospective, cohort study linked Scotland's hospitalization/death records on respiratory disorders to 4.65 million people in the 2001 census (providing ethnic group). For all-respiratory diseases and chronic obstructive pulmonary disease (COPD) from April 2001 to 2010 we calculated age, country of birth and Scottish Index of Multiple Deprivation (SIMD) adjusted risk ratios (RRs), by sex. We calculated hazard ratios (HRs) for death following hospitalization and for readmission. We multiplied ratios and confidence intervals (CIs) by 100, so the reference Scottish White population's RR/HR = 100.
  
  
  RESULTS
  RRs were comparatively low for all-respiratory diseases in Other White British (84.0, 95% CI 79.6, 88.6) and Chinese (67.4, 95% CI 55.2, 82.3) men and high in Pakistani men (138.1, 95% CI 125.5, 151.9) and women (132.7, 95% CI 108.8, 161.8). For COPD, White Irish men (142.5, 95% CI 125.3, 162.1) and women (141.9, CI 124.8, 161.3) and any Mixed Background men (161, CI 127.1, 203.9) and women (215.4, CI 158.2, 293.3) had high RRs, while Indian men (54.5, CI 41.9, 70.9) and Chinese women (50.5, CI 31.4, 81.1) had low RRs. In most non-White groups, mortality following hospitalization and readmission was similar or lower than the reference.
  
  
  CONCLUSIONS
  The pattern of ethnic variations in these respiratory disorders was complex and did not merely reflect smoking patterns. Readmission and death after hospitalization data did not signal inequity in services for ethnic minority groups.
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK raj.bhopal@ed.ac.uk.
authors.forename: Raj
authors.initials: R
authors.lastname: Bhopal
authors.affiliation: 2 Department of Child Health, School of Medicine, University of Aberdeen, Aberdeen, UK.
authors.forename: Markus F C
authors.initials: MF
authors.lastname: Steiner
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Cezard
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK 3 Cardiovascular Epidemiology Unit, The Department of Public Health and Primary Care, The Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Narinder
authors.initials: N
authors.lastname: Bansal
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK 4 Intelligence Information Services Division, NHS National Services, Edinburgh, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Fischbacher
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Colin R
authors.initials: CR
authors.lastname: Simpson
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Douglas
authors.affiliation: 1 Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK 5 Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy; D012140:Respiratory Tract Diseases / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D055815:Young Adult