Journal
ANNALS OF FAMILY MEDICINE
Volume 13, Issue 2, Pages 164-167Publisher
ANNALS FAMILY MEDICINE
DOI: 10.1370/afm.1757
Keywords
multimorbidity; chronic disease; hospital admission; cross-country analysis; population-based study; socioeconomic factors; health care system
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Funding
- Research Grants Council of Hong Kong
- Scottish Government, UK (Hong Kong-Scotland Partners in Post Doctoral Research) [S-CUHK402/12]
- University of Glasgow, UK
- Department of Health, Guangdong province, P.R. China [C2009006/2009-2013]
- Department of Education, Guangdong province, P.R. China [BKZZ2011047/2010-2013]
- Medical Research Fund, Chinese Medical Association, P.R. China [2010-08-05]
- Community Health Research Fund, Community Health Association of China, P.R. China [2012-2-91]
- Scottish School of Primary Care
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Associations of multimorbidity and income with hospital admission were investigated in population samples from 3 widely differing health care systems: Scotland (n = 36,921), China (n = 162,464), and Hong Kong (n = 29,187). Multimorbidity increased odds of admissions in all 3 settings. In Scotland, poorer people were more likely to be admitted (adjusted odds ratio [aOR] = 1.62; 95% CI, 1.41-1.86 for the lowest income group vs the highest), whereas China showed the opposite (aOR = 0.58; 95% CI, 0.56-0.60). In Hong Kong, poorer people were more likely to be admitted to public hospitals (aOR = 1.68; 95% CI, 1.36-2.07), but less likely to be admitted to private ones (aOR = 0.18; 95% CI, 0.13-0.25). Strategies to improve equitable health care should consider the impact of socioeconomic deprivation on the use of health care resources, particularly among populations with prevalent multimorbidity.
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