Distance to hospital and socioeconomic status influence secondary health care use

Figures & data

Table I. Use of secondary health care by patients in the studied population (percentage of all individuals in the population with the same variable).

	Emergency visit		Secondary health care costs		Hospitalization
	n	(%)	n	(%)	n	(%)
All	38 058	(12.1)	145 880	(46.5)	33 111	(10.5)
Gender:
Women	19 545	(12.3)	88 777	(55.9)	19 463	(12.3)
Men	18 512	(11.9)	57 099	(36.8)	13 644	(8.8)
Age:
20–39	9399	(9.5)	44 186	(44.4)	7832	(7.9)
40–59	10 165	(9.4)	43 854	(40.3)	6844	(6.3)
60–79	11 554	(14.5)	40 874	(51.2)	11 144	(14.0)
80–	6939	(26.7)	16 962	(65.2)	7287	(28.0)
Comorbidity:
RUB 0	186	(0.2)	1379	(1.4)	5	(0.0)
RUB 1	2969	(6.8)	24 033	(54.8)	533	(1.2)
RUB 2	7815	(12.1)	35 544	(55.0)	3384	(5.2)
RUB 3	18 625	(20.8)	71 298	(79.6)	19 525	(21.8)
RUB 4	6079	(55.8)	10 433	(95.7)	6853	(62.9)
RUB 5	2383	(74.1)	3189	(99.2)	2807	(87.3)
Distance to hospital:
0–19 km	29 137	(12.8)	107 499	(47.2)	24 384	(10.7)
20–39 km	5080	(10.9)	21 127	(45.3)	4779	(10.3)
> 40 km	2156	(9.0)	9907	(41.5)	2320	(9.7)
Missing	1685	(10.6)	7347	(46.0)	1628	(10.2)
Education level:^1
1	2839	(12.6)	10 339	(46.0)	2432	(10.8)
2	3250	(12.3)	11 850	(44.7)	2347	(8.9)
3	12 716	(10.0)	54 603	(43.1)	9458	(7.5)
4	6406	(7.9)	33 955	(42.0)	5439	(6.7)
Missing	725	(23.5)	1661	(53.8)	822	(26.6)
Income quartile:
1	11 726	(14.9)	40 148	(51.2)	11 386	(14.5)
2	11 483	(14.6)	42 657	(54.4)	11 204	(14.3)
3	7805	(9.9)	34 903	(44.5)	5878	(7.5)
4	7043	(9.0)	28 166	(35.9)	4 639	(5.9)
Missing	1	(0.5)	6	(3.0)	4	(1.9)

n = number; RUB = resource utilizations band; km = kilometre; ¹education level for individuals under age 70; education level 1 means the lowest education; income quartile 1 the lowest income.

Table II. Odds of receiving secondary health care in the studied population, adjusted for comorbidity, gender, and age.

	Emergency visit	Secondary health care costs	Days in hospital
	OR (CI)	OR (CI)	OR (CI)
Distance to the hospital:
0–19 km	1.00	1.00	1.00
20–39 km	0.96 (0.63–1.47)	0.92 (0.75–1.12)	1.01 (0.86–1.19)
over 40 km	0.71 (0.40–1.25)	0.73 (0.52–1.02)	0.86 (0.66–1.12)
Education level:
1	1.00	1.00
2	1.24 (0.85–1.82)	1.05 (0.99–1.12)
3	0.82 (0.60–1.12)	1.03 (0.98–1.09)
4	0.77 (0.55–1.08)	1.12** (1.05–1.19)
Income quartile:
1	1.00	1.00	1.00
2	0.83** (0.75–0.92)	1.04* (1.01–1.09)	1.04 (0.98–1.11)
3	0.97 (0.85–1.11)	1.00 (0.96–1.04)	0.89* (0.83–0.96)
4	0.99 (0.82–1.21)	0.96 (0.92–1.02)	0.91* (0.83–0.99)

OR = odds ratio; CI = confidence interval; km = kilometre; *p < 0.05, **p < 0.001.

Table III. Rate ratios of secondary health care use by patients, adjusted for comorbidity, gender, and age.

	Emergency visit	Secondary health care costs	Days in hospital
	IRR (CI)	IRR (CI)	IRR (CI)
Distance to the hospital:
0–19 km	1.00	1.00	1.00
20–39 km	0.81 (0.64–1.06)	0.99 (0.93–1.04)	0.95 (0.88–1.03)
over 40 km	0.71 (0.48–1.04)	0.91*** (0.88–0.94)	0.91* (0.84–0.98)
Education level:
1	1.00	1.00
2	1.03 (0.96–1.11)	1.16*** (1.08–1.24)
3	0.98 (0.92–1.04)	1.01 (0.95–1.06)
4	0.87* (0.78–0.98)	0.95 (0.90–1.01)
Income quartile:
1	1.00	1.00	1.00
2	0.99 (0.95–1.04)	0.92*** (0.89–0.96)	0.83* (0.78–0.88)
3	0.84***	0.78*** (0.78–0.90)	0.66* (0.75–0.82)
4	0.86**	0.78*** (0.79–0.95)	0.66* (0.75–0.81)

IRR = incidence rate ratio; CI = confidence interval; km = kilometre; *p < 0.05, **p < 0.01, ***p < 0.001.