Abstract
The relationship between socioeconomic factors and hospital use is not well understood in the Canadian context. We used the 1991 Canada census and 1990–92 Ontario hospital discharge abstracts for residents of southeast Toronto to calculate crude and age-sex adjusted rates of hospital admission, bed days, and costs by quintile of low-income households. Population-based rates of admission to hospital, bed days and costs were all significantly related to census tract income (p<0.01 for males and females). The number of admissions per person admitted was significantly associated with census tract income (p<0.01 for males and females), but length of stay and resource intensity weight were not. Hospital costs were 50.0% higher for the poorest quintile of neighbourhoods than for the wealthiest and 35.8% higher than for the middle-income quintile. Poor urban neighbourhoods may require more resources than previously anticipated, related to higher hospital admission and readmission rates.
Résumé
On ne comprend pas bien le rapport qui existe, au Canada, entre les indices socio-économiques et l’utilisation des services hospitaliers. Nous avons utilisé les données du recensement du Canada de 1991 et les résumés de congés d’hôpitaux des résidents du territoire du sud-est de Toronto, de 1990 à 1992, pour calculer les taux brutes et les taux ajustés (selon l’âge et le sexe), des admissions hospitalières, des jours-lits, et des coûts, pour chacun des quintiles de foyers à faibles revenus. Le taux d’admissions hospitalières pour chaque (population), de jours-lits et des coûts, étaient tous reliés, dans une mesure statistiquement significative, aux catégories de revenus (p<0.01 pour les hommes et les femmes), mais la durée de l’hospitalisation et l’intensité des ressources requises ne l’étaient pas. Les coûts hospitaliers encourus par le quintile des quartiers les plus pauvres étaient 50,0 % plus élevés que ceux des plus riches et 35 % plus élevés que ceux des quintiles à revenus moyens. Il est possible que les quartiers urbains pauvres requièrent plus de ressources qu’il ne l’avait été prévu, dû à des taux d’admissions et de réadmissions plus élevés.
Footnotes
Supported by grants from the Pan American Health Organization and the Wellesley Hospital Urban Health Initiative
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