TY - JOUR
T1 - Risk of respiratory hospitalization and death, readmission and subsequent mortality
T2 - Scottish health and ethnicity linkage study
AU - Bhopal, Raj
AU - Steiner, Markus Fc
AU - Cezard, Genevieve
AU - Bansal, Narinder
AU - Fischbacher, Colin
AU - Simpson, Colin R
AU - Douglas, Anne
AU - Sheikh, Aziz
AU - SHELS Researchers
N1 - Acknowledgements
ISD (Information Services Division) and National Records Scotland (NRS) made many contributions to the work. Anne Houghton, Arti Nair and Jenny Holmes gave secretarial help to prepare the article and to general administration. Judith Fernandez prepared the figure. AS is currently supported by The Commonwealth Fund, a private independent foundation based in New York City. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund, its directors, officers, or staff. The researchers acted independently of the funding body and the study sponsor (the University of Edinburgh) at all stages of the work. Other Contributions: These contributors served on the Steering Group and some on other important subgroups of SHELS, so gave general direction that helped this analysis. Chris Povey was a coapplicant
and the originator of the idea of linking the census data to the data held by ISD and he performed most of the linkage work including developing linkage methods. Prof. Jamie Pearce (coapplicant) advised especially on socio-economic adjustment. Duncan Buchanan (co-applicant) chaired the analysis subgroup.
Ganka Mueller (part study), Alex Stannard (part study) and Kirsty MacLachlan advised particularly in relation to NRS contributions. These important contributions did not meet ICMJE authorship requirements.
Access to data:
The data are not open access. They are only available with restricted access at National Records Scotland, and governed by strict ethical and other restrictions. Individual consent for linking these records was not sought. Access to SHELS is under consideration but researchers wishing to utilize the data should write to Prof. RB with a brief proposal.
Funding
We thank the Chief Scientist’s Office for the primary grant (CZH/4/648), and British Lung Foundation (RHotN12/) and NHS Health Scotland (no number) for Supplementary grants.
© The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - BACKGROUND: Limited and dated evidence shows ethnic inequalities in health status and health care in respiratory diseases. METHODS: This retrospective, cohort study linked Scotland's hospitalization/death records on respiratory disorders to 4.65 million people in the 2001 census (providing ethnic group). For all-respiratory diseases and chronic obstructive pulmonary disease (COPD) from April 2001 to 2010 we calculated age, country of birth and Scottish Index of Multiple Deprivation (SIMD) adjusted risk ratios (RRs), by sex. We calculated hazard ratios (HRs) for death following hospitalization and for readmission. We multiplied ratios and confidence intervals (CIs) by 100, so the reference Scottish White population's RR/HR = 100. RESULTS: RRs were comparatively low for all-respiratory diseases in Other White British (84.0, 95% CI 79.6, 88.6) and Chinese (67.4, 95% CI 55.2, 82.3) men and high in Pakistani men (138.1, 95% CI 125.5, 151.9) and women (132.7, 95% CI 108.8, 161.8). For COPD, White Irish men (142.5, 95% CI 125.3, 162.1) and women (141.9, CI 124.8, 161.3) and any Mixed Background men (161, CI 127.1, 203.9) and women (215.4, CI 158.2, 293.3) had high RRs, while Indian men (54.5, CI 41.9, 70.9) and Chinese women (50.5, CI 31.4, 81.1) had low RRs. In most non-White groups, mortality following hospitalization and readmission was similar or lower than the reference. CONCLUSIONS: The pattern of ethnic variations in these respiratory disorders was complex and did not merely reflect smoking patterns. Readmission and death after hospitalization data did not signal inequity in services for ethnic minority groups.
AB - BACKGROUND: Limited and dated evidence shows ethnic inequalities in health status and health care in respiratory diseases. METHODS: This retrospective, cohort study linked Scotland's hospitalization/death records on respiratory disorders to 4.65 million people in the 2001 census (providing ethnic group). For all-respiratory diseases and chronic obstructive pulmonary disease (COPD) from April 2001 to 2010 we calculated age, country of birth and Scottish Index of Multiple Deprivation (SIMD) adjusted risk ratios (RRs), by sex. We calculated hazard ratios (HRs) for death following hospitalization and for readmission. We multiplied ratios and confidence intervals (CIs) by 100, so the reference Scottish White population's RR/HR = 100. RESULTS: RRs were comparatively low for all-respiratory diseases in Other White British (84.0, 95% CI 79.6, 88.6) and Chinese (67.4, 95% CI 55.2, 82.3) men and high in Pakistani men (138.1, 95% CI 125.5, 151.9) and women (132.7, 95% CI 108.8, 161.8). For COPD, White Irish men (142.5, 95% CI 125.3, 162.1) and women (141.9, CI 124.8, 161.3) and any Mixed Background men (161, CI 127.1, 203.9) and women (215.4, CI 158.2, 293.3) had high RRs, while Indian men (54.5, CI 41.9, 70.9) and Chinese women (50.5, CI 31.4, 81.1) had low RRs. In most non-White groups, mortality following hospitalization and readmission was similar or lower than the reference. CONCLUSIONS: The pattern of ethnic variations in these respiratory disorders was complex and did not merely reflect smoking patterns. Readmission and death after hospitalization data did not signal inequity in services for ethnic minority groups.
KW - Respirartory diseases
KW - Respiratory hospitalizaton
KW - death
KW - Scottish health
KW - ethnicity
KW - ethnic minority
U2 - 10.1093/eurpub/ckv064
DO - 10.1093/eurpub/ckv064
M3 - Article
C2 - 25888579
VL - 25
SP - 769
EP - 774
JO - European Journal of Public Health
JF - European Journal of Public Health
SN - 1101-1262
IS - 5
ER -