CHEST
Volume 119, Issue 3, March 2001, Pages 708-713
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Clinical Investigations
Asthma and the Risk of Hospitalization in Canada: The Role of Socioeconomic and Demographic Factors

https://doi.org/10.1378/chest.119.3.708Get rights and content

Objective:

Asthma is an important determinant of hospitalization. The study aims to examine the modifying effects of demographic and socioeconomic factors on the relationship betweenasthma and the overall number of hospitalizations.

Methods:

We examined the data on 17,601 Canadians who were≥12 years of age to explore the combined effects of asthma and otherfactors on hospitalization with in the context of a publicly fundedhealth-care system. Asthma was determined by an affirmative response tothe question: “Do you have asthma diagnosed by a healthprofessional?” The subjects also were asked whether they had been anovernight patient in a hospital during the past 12 months.

Results:

Asthma as a risk factor explained 3.7% of allhospitalizations of men and 2.4% of all hospitalizations of women. Overall, hospitalization was positively associated with female gender, old age, and low household income. The odds ratio for asthma as a riskfactor for overall hospitalization (ie, hospitalization forany reason and all causes, not only for asthma) was greater for youngermen than for older men, for less-educated women than for well-educatedwomen, and for men with middle or high incomes than for men with lowincomes.

Conclusions:

These results suggest thatdemographic and socioeconomic factors play a role in the relationshipbetween asthma and the overall number of hospitalizations, with certainpopulation subgroups being at greater risk of hospitalization inrelation to asthma.

Section snippets

Materials and Methods

This analysis was based on data from the first cycle of the National Population Health Survey (NPHS), conducted by StatisticsCanada from 1994 to 1995. The methodology for this cross-sectionalstudy has been detailed elsewhere.11 In brief, the targetpopulation included household residents in all provinces, with theprincipal exclusion of populations on Indian reserves, Canadianmilitary bases, and some remote areas in Québec and Ontario. The NPHS used a two-stage stratified sampling design

Results

Table 1shows the crude 1-year cumulative incidence of overall hospitalizationin relation to various characteristics of the study participants. Thehospitalization incidence was higher among asthmatics (10.1% in menand 16.4% in women) than among nonasthmatic patients (6.9% in men and11.3% in women). The incidence was higher for less-educated subjects(8.4%) than for well-educated subjects (5.3%) in men, with similarresults for women. Those from low-income families were twice as likelyto be

Discussion

Asthma as a risk factor explains approximately 3% of overallhospitalization among Canadians ≥ 12 years of age. It is comparableto an estimate based on > 11 million hospital morbidity recordsduring a 3-year period (1994 to 1997; unpublished data) that 2.7% of total hospital admissions were because of asthma and relatedconditions. The following individual indicators of socioeconomic and demographic status increased the risk of overall hospitalization: olderage; female gender; and income. It seems

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Supported in part by National Health Research and Development Programgrant 6606–06-1998/2640023. Dr. Chen is a Canadian Institutes of Health Research/Social Sciences and Humanities Research Council of Canada/National Health Research and Development Program Investigator Award recipient.

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