Ecological measures of socioeconomic status and hospital readmissions for asthma among Canadian adults

Respir Med. 2004 May;98(5):446-53. doi: 10.1016/j.rmed.2003.11.005.


Background: Lack of an association between area-based socioeconomic status (SES) and readmission for asthma was investigated in a country with a universal health care system.

Methods: Data linkage analysis was conducted based on hospitalization data from Statistics Canada's Person-oriented Information Database and area-based SES data from the 1996 Census. Hospital records for 8333 asthma patients aged 20-64 years in all Canadian provinces except Quebec who were admitted in 1995/1996 were linked to determine the number of patients who were rehospitalized within the same fiscal year. The area-based SES of the patients was defined according to the average personal income and proportion of residents with a university degree in an enumeration area (EA). Incidence rates of readmission for asthma were calculated based on the total years at risk. Cox's proportional hazard model was used to adjust for age, sex, province, and length of stay for first admission.

Results: The incidence rate of asthma rehospitalization was 31.6 per 100 person-years for men and 37.2 per 100 person-years for women. Neither average EA income or education level was significantly associated with rehospitalization for asthma. Women living in poor areas tended to have an increased incidence of asthma rehospitalization, but the difference was not significant after adjustment for covariates using the Cox regression model.

Conclusion: Socioeconomic status measured at the neighborhood level has no significant impact on rehospitalization for asthma among Canadian adults.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Asthma / epidemiology*
  • Asthma / therapy
  • Canada / epidemiology
  • Educational Status
  • Female
  • Humans
  • Income
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Proportional Hazards Models
  • Residence Characteristics
  • Risk Factors
  • Sex Distribution
  • Socioeconomic Factors