ArticleJournal of epidemiology and community health2016
The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation.
Article in Journal of epidemiology and community health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 3 of them syntheses that pooled it.
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Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions.Nature human behaviour · 2026Pooled it
- The economic burden of Type 2 Diabetes by social determinants of health: A systematic review.PloS one · 2026Pooled it
- Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets.Environmental health : a global access science source · 2022Pooled it
- Regional variance in socioeconomic status among Dutch intensive care units: a nationwide cohort study of 588,568 ICU admissions.BMC health services research · 2026Article
- Addressing inequalities in the primary and secondary outpatient interface: A policy-focused evidence brief.Public health in practice (Oxford, England) · 2026Article
- Evaluating the impact of a parent champion model on bronchiolitis hospitalisation rates: a difference in differences study.Archives of disease in childhood · 2026Article
- The desirable health indicator: a new indicator of population health and healthcare utilisation.International journal of population data science · 2026Article
- Which social determinants of health and long-term conditions contribute to inequalities in avoidable emergency hospital admissions? A decomposition analysis of small-area data in England.BMJ public health · 2026Article
- Association of social isolation and loneliness with incident cancer in A Population-based cohort study.BMC public health · 2025Article
- Epidemiology of gender dysphoria and gender incongruence in children and young people attending primary care practices in England: retrospective cohort study.Archives of disease in childhood · 2025Article
- The impact of ageing, socio-economic differences and the evolution of morbidity on future health expenditure - a dynamic microsimulation.BMC health services research · 2025Article
- What works to reduce socioeconomic inequalities in hospitalisations and readmissions? Systematic review of the equity impacts of population-level, health service and integrative interventions.BMJ public health · 2025Article
- Postcode health inequalities in aortic valve surgery in North East England: retrospective study of disparities in presentation and hospital outcomes.BMJ public health · 2025Article
- Social and policy interventions to reduce hospital admissions among socioeconomically disadvantaged groups in OECD countries with universal health care: a systematic review.BMJ public health · 2025Article
- Modelling Adverse Events in Patients Receiving Chronic Oral Corticosteroids in the UK.PharmacoEconomics - open · 2024Article
- Lifetime healthcare expenditures across socioeconomic groups.BMC public health · 2024Article
- How can health systems approach reducing health inequalities? An in-depth qualitative case study in the UK.BMC public health · 2024Article
- Mapping the costs and socioeconomic characteristics involved in traumatic brain injuries: a scoping review.Journal of rehabilitation medicine · 2024Article
- Article
- Examining the hospital costs of children born into relative deprivation in England.Journal of epidemiology and community health · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThere are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course.
methodsHospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs.
resultsA steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy.
conclusionsSocioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples' entire lifetimes, despite increased costs due to longer life expectancies.
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