Higher rates of avoidable hospitalisation in low-income areas indicate greater healthcare needs of people living there. This should be addressed by investing in outpatient care for lower socioeconomic groups. The composition of individuals must be considered when studying area characteristics and avoidable hospitalisation.

There is inequality in public expenditure on health care at the end of life across socioeconomic groups in Stockholm. This phenomenon merits attention within Sweden, and beyond, in countries with less comprehensive welfare systems.

No abstract

As the proportion of deaths in hospital falls, it is important to ensure that social disadvantage has no role in determining place of death. This study investigated the association between individual sociodemographic factors and deaths in hospitals for the population of Stockholm County, Sweden, using linked population registers. In 2002, 14,517 (87%) of the 16,617 adult decedents in Stockholm County had contact with health services in the three years before they died. Twenty-two percent (3,210) of these deaths were in hospitals. Individual income, education, country of birth, and gender had no influence on likelihood of hospital death in multivariate analyses. Decedent characteristics associated with higher chance of hospital death included older age, being married, diagnosis of heart disease, and contact with ambulatory services (not family practitioners) in the three years before death. Cancer patients were no more or less likely than those without cancer to die in hospital. In health systems wishing to reduce an already low proportion of deaths in acute hospitals, enhancing palliative and social support for older patients and people with noncancer diagnoses may merit attention.

In the light of Mozambique's progress towards the achievement of Millennium Development Goal 4 of reducing mortality of children aged less than five years (under-five mortality) by two-thirds within 2015, this study investigated the relationship between the province of mother's residence and under-five mortality in Mozambique, using data from the 2003 Mozambican Demographic and Health Survey. The analyses included 10,326 children born within 10 years before the survey. Results of univariate and multivariate analyses showed a significant association between under-five mortality and province (region) of mother's residence. Children of mothers living in the North provinces (Niassa, Cabo Delgado, and Nampula) and the Central provinces (Zambezia, Sofala, Manica, and Tete) had higher risks of mortality than children whose mothers lived in the South provinces, especially Maputo province and Maputo city. However, controlling for the demographic, socioeconomic and environmental variables, the significance found between the place of mother's residence and under-five mortality reduced slightly. This suggests that other variables (income distribution and trade, density of population, distribution of the basic infrastructure, including healthcare services, climatic and ecologic factors), which were not included in the study, may have confounding effects. This study supports the thought that interventions aimed at reducing under-five mortality should be tailored to take into account the subnational/regional variation in economic development. However, research is warranted to further investigate the potential determinants behind the observed differences in under-five mortality.