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Distance to hospital and socioeconomic status influence secondary health care use

Zielinski, Andrzej ; Borgquist, Lars and Halling, Anders LU (2013) In Scandinavian Journal of Primary Health Care 31(2). p.83-88
Abstract
Objective. The aim of this study was to investigate how distance to hospital and socioeconomic status (SES) influence the use of secondary health care (SHC) when taking comorbidity into account. Design and setting. A register-based study in Ostergotland County. Subjects. The adult population of Ostergotland County. Main outcome measures. Odds of SHC use in the population and rates of SHC use by patients were studied after taking into account comorbidity level assigned using the Adjusted Clinical Groups (ACG) Case-Mix System. The baseline for analysis of SES was individuals with the lowest education level (level 1) and the lowest income (1st quartile). Results. The study showed both positive and negative association between SES and use of... (More)
Objective. The aim of this study was to investigate how distance to hospital and socioeconomic status (SES) influence the use of secondary health care (SHC) when taking comorbidity into account. Design and setting. A register-based study in Ostergotland County. Subjects. The adult population of Ostergotland County. Main outcome measures. Odds of SHC use in the population and rates of SHC use by patients were studied after taking into account comorbidity level assigned using the Adjusted Clinical Groups (ACG) Case-Mix System. The baseline for analysis of SES was individuals with the lowest education level (level 1) and the lowest income (1st quartile). Results. The study showed both positive and negative association between SES and use of SHC. The risk of incurring SHC costs was 12% higher for individuals with education level 1. Individuals with income in the 2nd quartile had a 4% higher risk of incurring SHC costs but a 17% lower risk of emergency department visits. Individuals with income in the 4th quartile had 9% lower risk of hospitalization. The risk of using SHC services for the population was not associated with distance to hospital. Patients living over 40 km from hospital and patients with higher SES had lower use of SHC services. Conclusions. It was found that distance to hospital and SES influence SHC use after adjusting for comorbidity level, age, and gender. These results suggest that GPs and health care managers should pay a higher degree of attention to this when planning primary care services in order to minimize the potentially redundant use of SHC. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Case-mix, comorbidity, general practice, geographical distance, health, care utilization, socioeconomic status, Sweden
in
Scandinavian Journal of Primary Health Care
volume
31
issue
2
pages
83 - 88
publisher
Taylor & Francis
external identifiers
  • wos:000318643200005
  • scopus:84877661001
  • pmid:23301541
ISSN
0281-3432
DOI
10.3109/02813432.2012.759712
language
English
LU publication?
yes
id
22d91307-1220-4aa4-a316-6e00f14ce29e (old id 3815312)
date added to LUP
2016-04-01 10:45:07
date last changed
2020-01-12 05:22:50
@article{22d91307-1220-4aa4-a316-6e00f14ce29e,
  abstract     = {Objective. The aim of this study was to investigate how distance to hospital and socioeconomic status (SES) influence the use of secondary health care (SHC) when taking comorbidity into account. Design and setting. A register-based study in Ostergotland County. Subjects. The adult population of Ostergotland County. Main outcome measures. Odds of SHC use in the population and rates of SHC use by patients were studied after taking into account comorbidity level assigned using the Adjusted Clinical Groups (ACG) Case-Mix System. The baseline for analysis of SES was individuals with the lowest education level (level 1) and the lowest income (1st quartile). Results. The study showed both positive and negative association between SES and use of SHC. The risk of incurring SHC costs was 12% higher for individuals with education level 1. Individuals with income in the 2nd quartile had a 4% higher risk of incurring SHC costs but a 17% lower risk of emergency department visits. Individuals with income in the 4th quartile had 9% lower risk of hospitalization. The risk of using SHC services for the population was not associated with distance to hospital. Patients living over 40 km from hospital and patients with higher SES had lower use of SHC services. Conclusions. It was found that distance to hospital and SES influence SHC use after adjusting for comorbidity level, age, and gender. These results suggest that GPs and health care managers should pay a higher degree of attention to this when planning primary care services in order to minimize the potentially redundant use of SHC.},
  author       = {Zielinski, Andrzej and Borgquist, Lars and Halling, Anders},
  issn         = {0281-3432},
  language     = {eng},
  number       = {2},
  pages        = {83--88},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Primary Health Care},
  title        = {Distance to hospital and socioeconomic status influence secondary health care use},
  url          = {http://dx.doi.org/10.3109/02813432.2012.759712},
  doi          = {10.3109/02813432.2012.759712},
  volume       = {31},
  year         = {2013},
}