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dc.contributor.authorGruer, L. D.
dc.contributor.authorMillard, A. D.
dc.contributor.authorWilliams, L. J.
dc.contributor.authorBhopal, R. S.
dc.contributor.authorKatikireddi, S. V.
dc.contributor.authorCézard, G. I.
dc.contributor.authorBuchanan, D.
dc.contributor.authorDouglas, A. F.
dc.contributor.authorSteiner, M. F. C.
dc.contributor.authorSheikh, A.
dc.identifier.citationGruer , L D , Millard , A D , Williams , L J , Bhopal , R S , Katikireddi , S V , Cézard , G I , Buchanan , D , Douglas , A F , Steiner , M F C & Sheikh , A 2018 , ' Differences in all-cause hospitalisation by ethnic group : a data linkage cohort study of 4.62 million people in Scotland, 2001–2013 ' , Public Health , vol. 161 , pp. 5-11 .
dc.identifier.otherPURE: 253210316
dc.identifier.otherPURE UUID: 983ccaf6-48a7-44a1-995e-3a50da32e224
dc.identifier.otherRIS: urn:444A41D1C239BB02E84BE3D4B29C0923
dc.identifier.otherScopus: 85047600893
dc.identifier.otherORCID: /0000-0002-3011-7416/work/60196717
dc.identifier.otherWOS: 000440018200003
dc.descriptionThe authors thank the Chief Scientist Office for a grant (CZH/4/648), NHS Health Scotland for a supplementary grant (no number). SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15) and Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). AS is supported by the Farr Institute.en
dc.description.abstractObjectives: Immigration into Europe has raised contrasting concerns about increased pressure on health services and equitable provision of health care to immigrants or ethnic minorities. Our objective was to find out if there were important differences in hospital use between the main ethnic groups in Scotland. Study design:  A census-based data linkage cohort study. Methods:  We anonymously linked Scotland's Census 2001 records for 4.62 million people, including their ethnic group, to National Health Service general hospitalisation records for 2001–2013. We used Poisson regression to calculate hospitalisation rate ratios (RRs) in 14 ethnic groups, presented as percentages of the White Scottish reference group (RR = 100), for males and females separately. We adjusted for age and socio-economic status and compared those born in the United Kingdom or the Republic of Ireland (UK/RoI) with elsewhere. We calculated mean lengths of hospital stay. Results:  9.79 million hospital admissions were analysed. Compared with the White Scottish, unadjusted RRs for both males and females in most groups were about 50–90, e.g. Chinese males 49 (95% confidence interval [CI] = 45–53) and Indian females 76 (95% CI 71–81). The exceptions were White Irish, males 120 (95% CI 117–124) and females 115 (95% CI 112–119) and Caribbean females, 103 (95% CI 85–126). Adjusting for age increased the RRs for most groups towards or above the reference. Socio-economic status had little effect. In many groups, those born outside the UK/RoI had lower admission rates. Unadjusted mean lengths of stay were substantially lower in most ethnic minorities. Conclusions:  Use of hospital beds in Scotland by most ethnic minorities was lower than by the White Scottish majority, largely explained by their younger average age. Other countries should use similar methods to assess their own experience.
dc.relation.ispartofPublic Healthen
dc.rights© 2018 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (
dc.subjectEthnic groupsen
dc.subjectData linkage cohorten
dc.subjectG Geography (General)en
dc.subjectH Social Sciences (General)en
dc.subjectZ665 Library Science. Information Scienceen
dc.titleDifferences in all-cause hospitalisation by ethnic group : a data linkage cohort study of 4.62 million people in Scotland, 2001–2013en
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Geography & Sustainable Developmenten
dc.description.statusPeer revieweden

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