title: Acute care hospitalization, by immigrant category: Linking hospital data and the Immigrant Landing File in Canada.
abstract: BACKGROUND
  Although immigrants tend to be healthier than the Canadian-born population when they arrive, subgroups, notably different immigration categories, may differ in health and health care use. Data limitations have meant the research has seldom focused on category of immigrant-economic, family or refugee. A newly linked database has made it possible to study acute care hospitalization by immigration category and source region.
  
  
  METHODS
  The Immigrant Landing File-Hospital Discharge Abstract Linked Database (n = 2.6 million) was used to derive sex-specific crude and age-standardized hospitalization rates (ASHRs) per 10,000 population for all-cause and leading causes of hospitalization during the 2006/2007-to-2008/2009 period.
  
  
  RESULTS
  Economic class immigrants had lower all-cause ASHRs than did their family class or refugee counterparts. Male refugees had high ASHRs overall and for circulatory diseases, digestive diseases, injury, and cancer. Female differences by immigrant class were less pronounced. All-cause ASHRs (excluding pregnancy) rose with years since arrival in Canada for male and female immigrants. Immigrants from East Asia had the lowest ASHRs; those from the United States, the highest.
  
  
  CONCLUSIONS
  Although hospital use is an imperfect indicator of health status, this study supports an initial healthy immigrant effect and its subsequent decline. Marked differences emerged among immigrant subgroups with some, notably refugees and immigrants from the United States, having significantly higher hospitalization rates overall and for leading causes, compared with other groups.
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: Health Analysis Division, Statistics Canada, the Ottawa Health Research Institute and the Institute of Clinical Evaluative Sciences.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Manuel
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D012307:Risk Factors
keywords: Data linkage; health care utilization; hospital records; immigrant health; refugees