ArticleBMJ open2018
Comparative morbidities and the share of emergencies in hospital admissions in deprived areas: a method and evidence from English administrative data.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Associations between housing tenure and unscheduled hospital use in people of working age with multiple physical and mental long-term conditions: a retrospective cohort study using linked data from London.BMC health services research · 2026Article
- Assessing inequalities in paediatric emergency department admissions in the Northwest of England: a retrospective cohort study.BMJ public health · 2026Article
- Examining Emergency Department Utilization and Hospital Admissions Among Older Undocumented Immigrants: Insights From a Primary Care County Program.The Gerontologist · 2025Article
- Neighbourhood socioeconomic conditions and emergency admissions for ambulatory care sensitive conditions in children: a longitudinal ecological analysis in England, 2012-2017.BMJ paediatrics open · 2025Article
- What can hospital emergency admissions prior to cancer diagnosis tell us about socio-economic inequalities in cancer diagnosis? Evidence from population-based data in England.British journal of cancer · 2024Article
- Are more GPs associated with a reduction in emergency hospital admissions? A quantitative study on GP referral in England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Measuring Health Equity in Emergency Care Using Routinely Collected Data: A Systematic Review.Health equity · 2021Review
- Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability.BMJ open · 2020Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveVarious studies find that the share of emergencies in hospital admissions is higher in deprived areas, but both the explanation and policy implications are unclear. We estimate the extent to which this finding is due to a different disease mix in deprived areas, rather than other explanations such as patient behaviour and general practitioner effectiveness.
designSecondary analysis using English Hospital Episode Statistics data, with disease for elective and emergency admissions in 2008/2009 coded at 186 blocks or 1230 categories and aggregated to lower layer super output area of residence. It is then linked to an appropriate measure of deprivation. OUTCOME MEASURES: The difference in the share of emergencies in hospital admissions between communities in the highest and lowest deciles of deprivation; and the percentage of this difference that is explained if areas in the least deprived decile have the same disease mix as those in the most deprived decile.
resultsUsing the finest disease classification scheme (1230 categories), 71% of the higher share of admissions that were emergencies in decile 1 areas relative to decile 10, is explained by the "adverse" case mix (CM) in deprived areas. The remainder reflects the higher relative use of emergency care in deprived areas for the same conditions. Higher incidence of respiratory and circulatory diseases in deprived areas explains about 30% of the CM contribution. Diseases of the digestive system and abdomen have a high relative use of emergency care in deprived areas.
conclusionsThe higher use of emergency care in deprived areas is primarily a symptom of the higher prevalence of diseases which have high national rates of emergency to elective care-especially respiratory diseases-rather than an indication of less effective primary care. Nevertheless, there is a higher share of emergency care in admissions in deprived areas for several diseases, most notably of the digestive system.
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