Evidence map›Paper›PMID 36471147›Full record

ArticleJournal of racial and ethnic health disparities2023

Health Resource Utilisation and Disparities: an Ecological Study of Admission Patterns Across Ethnicity in England Between 2017 and 2020.

C M Toal, A J Fowler, R M Pearse, Z Puthucheary, J R Prowle, Y I Wan

Abstract read
In one paragraph

Article in Journal of racial and ethnic health disparities, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Implementing and Delivering Culturally Centred Pharmacy Services Tailored to Ethnically Minoritised Populations: A Qualitative Systematic Review and Meta-Ethnography.Health expectations : an international journal of public participation in health care and health policy · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

C M ToalWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK. connor.toal@nhs.net.ORCID 0000-0001-9969-242X
A J FowlerWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.
R M PearseWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.
Z PuthuchearyWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.
J R ProwleWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.
Y I WanWilliam Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimThe COVID-19 pandemic highlighted adverse outcomes in Asian, Black, and ethnic minority groups. More research is required to explore underlying ethnic health inequalities. In this study, we aim to examine pre-COVID ethnic inequalities more generally through healthcare utilisation to contextualise underlying inequalities that were present before the pandemic.

designThis was an ecological study exploring all admissions to NHS hospitals in England from 2017 to 2020.

methodsThe primary outcomes were admission rates within ethnic groups. Secondary outcomes included age-specific and age-standardised admission rates. Sub-analysis of admission rates across an index of multiple deprivation (IMD) deciles was also performed to contextualise the impact of socioeconomic differences amongst ethnic categories. Results were presented as a relative ratio (RR) with 95% confidence intervals.

resultsAge-standardised admission rates were higher in Asian (RR 1.40 [1.38-1.41] in 2019) and Black (RR 1.37 [1.37-1.38]) and lower in Mixed groups (RR 0.91 [0.90-0.91]) relative to White. There was significant missingness or misassignment of ethnicity in NHS admissions: with 11.7% of admissions having an unknown/not-stated ethnicity assignment and 'other' ethnicity being significantly over-represented. Admission rates did not mirror the degree of deprivation across all ethnic categories.

conclusionsThis study shows Black and Asian ethnic groups have higher admission rates compared to White across all age groups and when standardised for age. There is evidence of incomplete and misidentification of ethnicity assignment in NHS admission records, which may introduce bias to work on these datasets. Differences in admission rates across individual ethnic categories cannot solely be explained by socioeconomic status. Further work is needed to identify ethnicity-specific factors of these inequalities to allow targeted interventions at the local level.

Indexed as

EthnicityPandemicsEnglandHealth ResourcesHumansMinority GroupsEthnicityHealth inequalitySecondary careSocioeconomic deprivation

Identifiers

PMID36471147
PMCPMC9734479

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.