Frank Olsen 1,2 , Lise Balteskard 2 , Bård Uleberg 3,2 , Bjarne K Jacobsen 3,2,4 , Ivar Heuch 5 , Atle Moen 6 Show Affiliations »
Abstract
OBJECTIVES: To assess the impact of parental educational level on hospital admissions for children, and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. DESIGN: National cohort study. SETTING: The 18 hospital referral areas for children in Norway. PARTICIPANTS: All Norwegian children aged 1-16 years in the period 2008-2016 and their parents. MAIN OUTCOME MEASURES: Age- and gender-adjusted admission rates and probability of admission. RESULTS: Of 1 538 189 children, 156 087 (10.2%) had at least one admission in the study period. There was a nearly twofold (1.9) variation in admission rates between the hospital referral areas (3113 per 100 000 children, 95% CI: 3056 to 3169 vs 1627, 95% CI: 1599 to 1654). Area level variances in multilevel analysis did not change after adjusting for parental level of education. Children of parents with low level of education (maternal level of education, low vs high) had the highest admission rates (2016: 2587, 95% CI: 2512 to 2662 vs 1810, 95% CI: 1770 to 1849), the highest probability of being admitted (OR: 1.18, 95% CI: 1.16 to 1.20), the highest number of admissions (incidence rate ratio: 1.05, 95% CI: 1.01 to 1.10) and admissions with lower cost (-0.5%, 95% CI: -1.2% to 0.3%). CONCLUSIONS: Substantial geographic variation in hospital admission rates for children was found, but was not explained by parental educational level. Children of parents with low educational level had the highest admission probability, and the highest number of admissions, but the lowest cost of admissions. Our results suggest that the variation between the educational groups is not due to differences in medical needs, and may be characterised as unwarranted. However, the manner in which health professionals communicate and interact with parents with different educational levels might play an important role. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVES: To assess the impact of parental educational level on hospital admissions for children , and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. DESIGN: National cohort study. SETTING: The 18 hospital referral areas for children in Norway. PARTICIPANTS : All Norwegian children aged 1-16 years in the period 2008-2016 and their parents. MAIN OUTCOME MEASURES: Age - and gender-adjusted admission rates and probability of admission. RESULTS: Of 1 538 189 children , 156 087 (10.2%) had at least one admission in the study period. There was a nearly twofold (1.9) variation in admission rates between the hospital referral areas (3113 per 100 000 children , 95% CI: 3056 to 3169 vs 1627, 95% CI: 1599 to 1654). Area level variances in multilevel analysis did not change after adjusting for parental level of education. Children of parents with low level of education (maternal level of education, low vs high) had the highest admission rates (2016: 2587, 95% CI: 2512 to 2662 vs 1810, 95% CI: 1770 to 1849), the highest probability of being admitted (OR: 1.18, 95% CI: 1.16 to 1.20), the highest number of admissions (incidence rate ratio: 1.05, 95% CI: 1.01 to 1.10) and admissions with lower cost (-0.5%, 95% CI: -1.2% to 0.3%). CONCLUSIONS: Substantial geographic variation in hospital admission rates for children was found, but was not explained by parental educational level. Children of parents with low educational level had the highest admission probability, and the highest number of admissions, but the lowest cost of admissions. Our results suggest that the variation between the educational groups is not due to differences in medical needs, and may be characterised as unwarranted. However, the manner in which health professionals communicate and interact with parents with different educational levels might play an important role. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Disease
Gene
Species
Keywords:
community child health; epidemiology; health policy; public health
Mesh： See more »
Year: 2021
PMID： 34158300 DOI： 10.1136/bmjopen-2020-046656
Source DB: PubMed Journal: BMJ Open ISSN： 2044-6055 Impact factor: 2.692