Abstract：
OBJECTIVES: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 <1km compared to ≥2km) 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.
journal_name
Health Placejournal_title
Health & placeauthors
Schooling CM,Kwok MK,Yau C,Cowling BJ,Lam TH,Leung GMdoi
10.1016/j.healthplace.2011.06.011subject
Has Abstractpub_date
2011-09-01 00:00:00pages
1038-43issue
5eissn
1353-8292issn
1873-2054pii
S1353-8292(11)00115-8journal_volume
17pub_type
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