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Impact of parents' education on variation in hospital admissions for children: a population-based cohort study
OBJECTIVES: To assess the impact of parental educational level on hospital admissions for children, and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. DESIGN: National cohort study. SETTING: The 18 hospital referral areas for c...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220478/ https://www.ncbi.nlm.nih.gov/pubmed/34158300 http://dx.doi.org/10.1136/bmjopen-2020-046656 |
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author | Olsen, Frank Balteskard, Lise Uleberg, Bård Jacobsen, Bjarne K Heuch, Ivar Moen, Atle |
author_facet | Olsen, Frank Balteskard, Lise Uleberg, Bård Jacobsen, Bjarne K Heuch, Ivar Moen, Atle |
author_sort | Olsen, Frank |
collection | PubMed |
description | OBJECTIVES: To assess the impact of parental educational level on hospital admissions for children, and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. DESIGN: National cohort study. SETTING: The 18 hospital referral areas for children in Norway. PARTICIPANTS: All Norwegian children aged 1–16 years in the period 2008–2016 and their parents. MAIN OUTCOME MEASURES: Age- and gender-adjusted admission rates and probability of admission. RESULTS: Of 1 538 189 children, 156 087 (10.2%) had at least one admission in the study period. There was a nearly twofold (1.9) variation in admission rates between the hospital referral areas (3113 per 100 000 children, 95% CI: 3056 to 3169 vs 1627, 95% CI: 1599 to 1654). Area level variances in multilevel analysis did not change after adjusting for parental level of education. Children of parents with low level of education (maternal level of education, low vs high) had the highest admission rates (2016: 2587, 95% CI: 2512 to 2662 vs 1810, 95% CI: 1770 to 1849), the highest probability of being admitted (OR: 1.18, 95% CI: 1.16 to 1.20), the highest number of admissions (incidence rate ratio: 1.05, 95% CI: 1.01 to 1.10) and admissions with lower cost (−0.5%, 95% CI: −1.2% to 0.3%). CONCLUSIONS: Substantial geographic variation in hospital admission rates for children was found, but was not explained by parental educational level. Children of parents with low educational level had the highest admission probability, and the highest number of admissions, but the lowest cost of admissions. Our results suggest that the variation between the educational groups is not due to differences in medical needs, and may be characterised as unwarranted. However, the manner in which health professionals communicate and interact with parents with different educational levels might play an important role. |
format | Online Article Text |
id | pubmed-8220478 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-82204782021-07-09 Impact of parents' education on variation in hospital admissions for children: a population-based cohort study Olsen, Frank Balteskard, Lise Uleberg, Bård Jacobsen, Bjarne K Heuch, Ivar Moen, Atle BMJ Open Health Services Research OBJECTIVES: To assess the impact of parental educational level on hospital admissions for children, and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. DESIGN: National cohort study. SETTING: The 18 hospital referral areas for children in Norway. PARTICIPANTS: All Norwegian children aged 1–16 years in the period 2008–2016 and their parents. MAIN OUTCOME MEASURES: Age- and gender-adjusted admission rates and probability of admission. RESULTS: Of 1 538 189 children, 156 087 (10.2%) had at least one admission in the study period. There was a nearly twofold (1.9) variation in admission rates between the hospital referral areas (3113 per 100 000 children, 95% CI: 3056 to 3169 vs 1627, 95% CI: 1599 to 1654). Area level variances in multilevel analysis did not change after adjusting for parental level of education. Children of parents with low level of education (maternal level of education, low vs high) had the highest admission rates (2016: 2587, 95% CI: 2512 to 2662 vs 1810, 95% CI: 1770 to 1849), the highest probability of being admitted (OR: 1.18, 95% CI: 1.16 to 1.20), the highest number of admissions (incidence rate ratio: 1.05, 95% CI: 1.01 to 1.10) and admissions with lower cost (−0.5%, 95% CI: −1.2% to 0.3%). CONCLUSIONS: Substantial geographic variation in hospital admission rates for children was found, but was not explained by parental educational level. Children of parents with low educational level had the highest admission probability, and the highest number of admissions, but the lowest cost of admissions. Our results suggest that the variation between the educational groups is not due to differences in medical needs, and may be characterised as unwarranted. However, the manner in which health professionals communicate and interact with parents with different educational levels might play an important role. BMJ Publishing Group 2021-06-22 /pmc/articles/PMC8220478/ /pubmed/34158300 http://dx.doi.org/10.1136/bmjopen-2020-046656 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Health Services Research Olsen, Frank Balteskard, Lise Uleberg, Bård Jacobsen, Bjarne K Heuch, Ivar Moen, Atle Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title | Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title_full | Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title_fullStr | Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title_full_unstemmed | Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title_short | Impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
title_sort | impact of parents' education on variation in hospital admissions for children: a population-based cohort study |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220478/ https://www.ncbi.nlm.nih.gov/pubmed/34158300 http://dx.doi.org/10.1136/bmjopen-2020-046656 |
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