Article Text


Epidemiology and policy
SP3-47 Spatial proximity and childhood hospital admissions in a densely populated conurbation: evidence from Hong Kong's “Children of 1997” birth cohort
  1. C M Schooling,
  2. C Yau,
  3. M K Kwok,
  4. B J Cowling,
  5. T H Lam,
  6. G M Leung
  1. Life course and Lifestyle Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China


Introduction Physical distance is a barrier to hospital utilisation. In a very densely populated city in China, we examined whether use of public hospitals by children was associated with individual-level residential proximity, and whether these associations varied with type of admission.

Methods The authors used multivariable negative binomial regression in a large, population-representative birth cohort to examine the adjusted associations of proximity to hospitals with Accidents and Emergency services, proxied by distance to the nearest such hospital, with hospital admissions, bed-days and average length of stay from 8 days to 8 years of age.

Results Physical proximity was positively associated with emergency admissions in children (incidence rate ratio (IRR) 1.23, 95% CI 1.11 to 1.35 for <1 km compared to ≥2 km) and bed-days but not with average length of stay, adjusted for age, sex and socio-economic position. However, in a similar comparison there was no such association for other (ie, planned) admissions (IRR 1.04, 95% CI 0.85 to 1.27).

Conclusion Proximity was associated with hospital use for emergency admissions. Given the societal costs of such use and the risks of iatrogenesis, attention should focus on achieving a more effective use of scarce resources.

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