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Ann Fam Med. 2015 Mar;13(2):164-7. doi: 10.1370/afm.1757.

Relationships of multimorbidity and income with hospital admissions in 3 health care systems.

Author information

1
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.
2
School of Public Health, Guangzhou Medical University, Guangzhou, Peoples' Republic of China.
3
Centre for Research Excellence in the Prevention of Chronic Conditions in Rural & Remote Populations, James Cook University, Cairns, Queensland, Australia.
4
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
5
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
6
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom Stewart.Mercer@glasgow.ac.uk.

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.

KEYWORDS:

chronic disease; cross-country analysis; health care system; hospital admission; multimorbidity; population-based study; socioeconomic factors

PMID:
25755038
PMCID:
PMC4369606
DOI:
10.1370/afm.1757
[Indexed for MEDLINE]
Free PMC Article

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