Differences in all-cause hospitalisation by ethnic group: a data linkage cohort study of 4.62 million people in Scotland, 2001–2013

Laurence Gruer, A Millard, Linda Williams, Rajinder Bhopal, Srinivasa Vittal Katikireddi, Genevieve Cezard, D. Buchanan, A Douglas, Markus F C Steiner, Aziz Sheikh

Research output: Contribution to journalArticlepeer-review


Objectives: 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 2001e2013. We used Poisson regression to calculate hospitalisation rate ratios (RRs) in 14 ethnic groups, presented as percentages of the White Scottish reference group (RR ¼ 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 50e90, e.g. Chinese males 49 (95% confidence interval [CI] ¼ 45e53) and Indian females 76 (95% CI 71e81). The exceptions were White Irish, males 120 (95% CI 117e124) and females 115 (95% CI 112e119) and Caribbean females, 103 (95% CI 85e126). 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 bythe White Scottish majority, largely explained by their younger average age. Other countries should use similar methods to assess their own experience.
Original languageEnglish
Pages (from-to)5
Number of pages11
JournalPublic Health
Early online date28 May 2018
Publication statusE-pub ahead of print - 28 May 2018


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