Social inequalities and hospital admission for unintentional injury in young children in Scotland: A nationwide linked cohort study

Henery, Paul; Dundas, Ruth; Katikireddi, Srinivasa Vittal; Leyland, Alastair H.; Wood, Rachael; Pearce, Anna

doi:10.1016/j.lanepe.2021.100117

Cited by 11 publications

(19 citation statements)

References 26 publications

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“…But of those that had an attendance, SES quintile was not associated with conversion probability. As conversion probabilities do not vary significantly between IMD quintile, it suggests that infants living in poorer areas may be exposed to further risk factors (not included in our models) that increase the risk of acute infection and injuries (such as exposure to adverse housing conditions, overcrowding, environmental tobacco smoke) [62][63][64]. This may result in higher A&E attendance rates and proportionate increases in admission rates, compared to children living in less deprived areas.…”

Section: Comparison With Other Studies and Implications For Policymentioning

confidence: 94%

Determinants of accident and emergency attendances and emergency admissions in infants: birth cohort study

Nath

Zylbersztejn

Viner

et al. 2022

BMC Health Serv Res

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Background There is limited understanding of the drivers of increasing infant accident and emergency (A&E) attendances and emergency hospital admissions across England. We examine variations in use of emergency hospital services among infants by local areas in England and investigate the extent to which infant and socio-economic factors explain these variations. Methods Birth cohort study using linked administrative Hospital Episode Statistics data in England. Singleton live births between 1-April-2012 and 31-March-2019 were followed up for 1 year; from 1-April-2013 (from the discharge date of their birth admission) until their first birthday, death or 31-March-2019. Mixed effects negative binomial models were used to calculate incidence rate ratios for A&E attendances and emergency admissions and mixed effects logistic regression models estimated odds ratio of conversion (the proportion of infants subsequently admitted after attending A&E). Models were adjusted for individual-level factors and included a random effect for local authority (LA). Results The cohort comprised 3,665,414 births in 150 English LAs. Rates of A&E attendances and emergency admissions were highest amongst: infants born < 32 weeks gestation; with presence of congenital anomaly; and to mothers < 20-years-old. Area-level deprivation was positively associated with A&E attendance rates, but not associated with conversion probability. A&E attendance rates were highest in the North East (916 per 1000 child-years, 95%CI: 911 to 921) and London (876 per 1000, 95%CI: 874 to 879), yet London had the lowest emergency admission rates (232 per 1000, 95%CI: 231 to 234) and conversion probability (25% vs 39% in South West). Adjusting for individual-level factors did not significantly affect variability in A&E attendance and emergency admission rates by local authority. Conclusions Drivers of A&E attendances and emergency admissions include individual-level factors such being born premature, with congenital anomaly and from socio-economically disadvantaged young parent families. Support for such vulnerable infants and families should be provided alongside preventative health care in primary and community care settings. The impact of these services requires further investigation. Substantial geographical variations in rates were not explained by individual-level factors. This suggests more detailed understanding of local and underlying service-level factors would provide targets for further research on mechanisms and policy priority.

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Section: Comparison With Other Studies and Implications For Policymentioning

confidence: 94%

Determinants of accident and emergency attendances and emergency admissions in infants: birth cohort study

Nath

Zylbersztejn

Viner

et al. 2022

BMC Health Serv Res

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“…SIMD deprivation ranks are most commonly used to categorise data zones into population-weighted deprivation quantiles (e.g., Authors, 2018Authors, , 2021Covvey et al, 2014;Henery et al, 2021;Thompson et al, 2013). For example, the data zones which, after ranking by deprivation, cumulatively contain 10% of the total population in the most deprived areas are assigned to deprivation decile 1 in the SIMD ordering convention.…”

Section: Composite Measure Of Multiple Deprivationmentioning

confidence: 99%

Assessing the risk of endogeneity bias in health and mortality inequalities research using composite measures of multiple deprivation which include health-related indicators: A case study using the Scottish Index of Multiple Deprivation and population health and mortality data

Bradford

Allik

McMahon

et al. 2022

Preprint

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The inclusion of health-related indicators in composite measures of multiple deprivation introduces a risk of endogeneity bias when using the latter in health inequalities research. This bias may ultimately result in the inappropriate allocation of healthcare resources and maintenance of preventable health inequalities. Mitigation strategies to avoid this bias include removing the health-related indicators or using single constituent domains (such as income or employment class) in isolation. These strategies have not been widely validated. This study used population-level health and mortality data with a contemporary composite measure of multiple deprivation (Scottish Index of Multiple Deprivation; SIMD) to assess these mitigation strategies. The differences between deprivation methods (original, health excluded, and income domain) were negligible. The results of quantitative research on health inequalities are unlikely to be affected by endogeneity bias.

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“…The majority of these injuries falls into unintentional injuries (90%) [1]. Although these injuries are preventable, they are still prevalent especially in low-income countries where children are more likely to experience and die from unintentional injury [2]. An unintentional injury is defined as an "injury occurring due to nonpremeditated acute transfer of mechanical, chemical, thermal or electrical energy or radiation" [3,4], and the leading causes are road traffic injuries, falls, burns, poisonings and drowning [1,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of unintentional injuries in hospitalised children and adolescents - national retrospective study

et al. 2023

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Introduction/Objective. Unintentional injuries is a global health issue among children and adolescents. The aim of this study was to examine the characteristics of unintentional injuries divided according to different age groups and sex among the children and adolescents who have been hospitalised in public hospitals of the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective analysis of the e-base of the Agency for certification, accreditation and health care quality improvement of the Republic of Srpska data were collected from 10 public hospitals for patients aged ?19 years, who have been hospitalised for unintentional injuries in the period of January 2018 and December 2020. Results. The study identified 1,336 patients who were hospitalised for unintentional injuries, most of whom were boys (67.4%). Falls were the most frequent cause of hospitalisation in children of all age categories (aged 1 (70.6%), 1 to 4 (59.1%), 5 to 9 (68.5%)) and adolescents aged 10-14 (64.1%), while road traffic injuries were the leading cause of hospitalisation in adolescents aged 15 to 19 (62.6%). The cause of injury for the hospitalised patients were significantly related to age (p < 0.001) and sex (p < 0.05) groups. According to the nature of the injury in relation to the area of the body, the most frequent injuries were to the head (41.1%), caused by traffic accidents and falls. Conclusion. Since falls and road traffic injuries were the leading causes of hospitalisation, preventive measures should be taken to reduce the frequency of these injuries.

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Social inequalities and hospital admission for unintentional injury in young children in Scotland: A nationwide linked cohort study

Cited by 11 publications

References 26 publications

Determinants of accident and emergency attendances and emergency admissions in infants: birth cohort study

Determinants of accident and emergency attendances and emergency admissions in infants: birth cohort study

Assessing the risk of endogeneity bias in health and mortality inequalities research using composite measures of multiple deprivation which include health-related indicators: A case study using the Scottish Index of Multiple Deprivation and population health and mortality data

Characteristics of unintentional injuries in hospitalised children and adolescents - national retrospective study

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