Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong

Geospat Health. 2011 Nov;6(1):13-20. doi: 10.4081/gh.2011.153.


Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rates by stroke subtype among the population aged 35 years and above in 1999-2007. Multilevel models were used to examine the spatio-temporal variations. Ischemic stroke incidence was found to decrease among those aged above 55 years, while hemorrhagic stroke incidence increased. Ischemic stroke case-fatality was found to decrease but hemorrhagic stroke case-fatality remained stable. For both subtypes, there were significant variations in stroke incidence and case-fatality across the districts of residence, but insignificant variations across HA service clusters. Only variations in ischemic stroke incidence and hemorrhagic stroke case-fatality at the district level could be partly explained by district-level SES. Identification of districts with higher risk for stroke incidence and case-fatality would help to formulate enhanced preventive measures. Future studies are needed to identify factors that contribute to the geographical variations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Geography
  • Healthcare Disparities*
  • Hong Kong / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Sex Factors
  • Small-Area Analysis*
  • Socioeconomic Factors
  • Stroke / classification
  • Stroke / epidemiology*
  • Stroke / mortality