title: Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: a population-based data linkage study.
abstract: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants.
  
  
  
  Prospective population-based linked data set.
  
  
  
  All preterm babies born in Western Australia during 2010 and 2011.
  
  
  
  All-cause hospitalisations and emergency department presentations.
  
  
  
  There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22).
  
  
  
  In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.
authors.affiliation: School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Strobel
authors.affiliation: Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Peter
authors.affiliation: School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Kimberley E
authors.initials: KE
authors.lastname: McAuley
authors.affiliation: School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.|Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Western Australia, Australia.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: McAullay
authors.affiliation: School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Marriott
authors.affiliation: School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Edmond
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007234:Infant, Premature; D016247:Information Storage and Retrieval; D008297:Male; D008429:Maternal Welfare; D011446:Prospective Studies; D012959:Socioeconomic Factors; D035862:Vulnerable Populations; D014904:Western Australia / Q000453:epidemiology; D044465:White People
keywords: EPIDEMIOLOGY; Hospital utilisation; Preterm infants