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  • Title: Spatial proximity and childhood hospital admissions in a densely populated conurbation: evidence from Hong Kong's 'Children of 1997' birth cohort.
    Author: Schooling CM, Kwok MK, Yau C, Cowling BJ, Lam TH, Leung GM.
    Journal: Health Place; 2011 Sep; 17(5):1038-43. PubMed ID: 21798790.
    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.
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