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Article: Spatial proximity and childhood hospital admissions in a densely populated conurbation: Evidence from Hong Kong's 'Children of 1997' birth cohort

TitleSpatial proximity and childhood hospital admissions in a densely populated conurbation: Evidence from Hong Kong's 'Children of 1997' birth cohort
Authors
KeywordsChild health
Geographically weighted regression
Health services accessibility
Hospitals
Medical geography
Issue Date2011
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/healthplace
Citation
Health And Place, 2011, v. 17 n. 5, p. 1038-1043 How to Cite?
AbstractObjectives: Physical distance affects hospital use. In a densely populated city in China, we examined if child public hospital use was associated with individual-level proximity, and any differences by admission type or geo-spatially. Methods: We used negative binomial regression in a large, population-representative birth cohort to examine the adjusted associations of proximity to emergency facilities (A&E) with hospital admissions, bed-days and length of stay from 8 days to 8 years of age. We used geographically weighted regression to assess geo-spatial variation. Results: Proximity was positively associated with emergency admissions (incidence rate ratio (IRR) 1.21, 95% confidence interval (CI) 1.10 to 1.34 for <1. km compared to ≥2. km) and bed-days but not with length of stay, adjusted for parental education and mother's birthplace. There was no such association for other admissions (IRR 1.03, 95% CI 0.84 to 1.26). There was little geo-spatial variation. Conclusions: Proximity was associated with 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. © 2011 Elsevier Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/151753
ISSN
2015 Impact Factor: 2.441
2015 SCImago Journal Rankings: 1.559
ISI Accession Number ID
Funding AgencyGrant Number
Health Care and Promotion Fund
Health and Welfare Bureau, Government of the Hong Kong SAR [HCPF]216106
Health and Health Services Research Fund [HHSRF]03040771
Research Fund for the Control of Infectious Diseases in Hong Kong [RFCID]04050172
Government of the Hong Kong SAR
University Research Committee Strategic Research Theme (SRT) of Public Health, The University of Hong Kong
Funding Information:

This work is a sub-study of the "Children of 1997" birth cohort, which was initially supported by the Health Care and Promotion Fund, Health and Welfare Bureau, Government of the Hong Kong SAR [HCPF Grant # 216106] and re-established in 2005 funded by the Health and Health Services Research Fund [HHSRF Grants #03040771]. This sub-study was funded by the Research Fund for the Control of Infectious Diseases in Hong Kong [RFCID Grant # 04050172], Government of the Hong Kong SAR, and the University Research Committee Strategic Research Theme (SRT) of Public Health, The University of Hong Kong.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorMary Schooling, Cen_HK
dc.contributor.authorKi Kwok, Men_HK
dc.contributor.authorYau, Cen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorHing Lam, Ten_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2012-06-26T06:27:51Z-
dc.date.available2012-06-26T06:27:51Z-
dc.date.issued2011en_HK
dc.identifier.citationHealth And Place, 2011, v. 17 n. 5, p. 1038-1043en_HK
dc.identifier.issn1353-8292en_HK
dc.identifier.urihttp://hdl.handle.net/10722/151753-
dc.description.abstractObjectives: Physical distance affects hospital use. In a densely populated city in China, we examined if child public hospital use was associated with individual-level proximity, and any differences by admission type or geo-spatially. Methods: We used negative binomial regression in a large, population-representative birth cohort to examine the adjusted associations of proximity to emergency facilities (A&E) with hospital admissions, bed-days and length of stay from 8 days to 8 years of age. We used geographically weighted regression to assess geo-spatial variation. Results: Proximity was positively associated with emergency admissions (incidence rate ratio (IRR) 1.21, 95% confidence interval (CI) 1.10 to 1.34 for <1. km compared to ≥2. km) and bed-days but not with length of stay, adjusted for parental education and mother's birthplace. There was no such association for other admissions (IRR 1.03, 95% CI 0.84 to 1.26). There was little geo-spatial variation. Conclusions: Proximity was associated with 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. © 2011 Elsevier Ltd.en_HK
dc.languageengen_US
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/healthplaceen_HK
dc.relation.ispartofHealth and Placeen_HK
dc.subjectChild healthen_HK
dc.subjectGeographically weighted regressionen_HK
dc.subjectHealth services accessibilityen_HK
dc.subjectHospitalsen_HK
dc.subjectMedical geographyen_HK
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshEmergency Service, Hospital - Utilizationen_US
dc.subject.meshFemaleen_US
dc.subject.meshGeographyen_US
dc.subject.meshHealth Services Accessibilityen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHospitals, Public - Utilizationen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshLength Of Stayen_US
dc.subject.meshMaleen_US
dc.subject.meshPatient Admission - Statistics & Numerical Dataen_US
dc.subject.meshPopulation Densityen_US
dc.subject.meshRegression Analysisen_US
dc.titleSpatial proximity and childhood hospital admissions in a densely populated conurbation: Evidence from Hong Kong's 'Children of 1997' birth cohorten_HK
dc.typeArticleen_HK
dc.identifier.emailMary Schooling, C: cms1@hkucc.hku.hken_HK
dc.identifier.emailYau, C: cynthia-yau@hkucc.hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailHing Lam, T: hrmrlth@hkucc.hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.authorityMary Schooling, C=rp00504en_HK
dc.identifier.authorityYau, C=rp00829en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityHing Lam, T=rp00326en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.healthplace.2011.06.011en_HK
dc.identifier.pmid21798790-
dc.identifier.scopuseid_2-s2.0-80052542242en_HK
dc.identifier.hkuros197245-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052542242&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1038en_HK
dc.identifier.epage1043en_HK
dc.identifier.isiWOS:000295858000004-
dc.publisher.placeUnited Kingdomen_HK
dc.relation.projectShort- and medium-term outcomes of accelerated infant growth in Hong Kong Chinese birth cohort-
dc.relation.projectInfectious illness and secondhand smoke exposure in utero and during the first 8 years of life-
dc.identifier.scopusauthoridMary Schooling, C=12808565000en_HK
dc.identifier.scopusauthoridKi Kwok, M=43661496400en_HK
dc.identifier.scopusauthoridYau, C=7007038452en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridHing Lam, T=7202522876en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.citeulike9622210-

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