Men in low socio-economic groups are at highest risk for potentially avoidable hospitalization, according to a study by the Canadian Institute for Health Information (CIHI). Overall, the rate of hospitalization increases as socio-economic status decreases for both men and women in 33 cities in Canada. The recent study expands on the 2008 report “Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada” by measuring the size and estimated cost of health disparities in hospitalization rates among different socio-economic groups in urban Canada.
The analysis focused on conditions, such as mental illness, for which hospitalization could be potentially avoided by providing preventive care and early disease management outside the hospital, such as through primary health care. In cases of mental illness, hospitalization rates were also higher for males than for females. This translates to excess costs of $123 million for males and $125 million for females, as women make up a larger proportion of the population in the urban areas studied. The pattern changes slightly when looking within the same socio-economic group across the metropolitan areas: females tended to have higher rates of hospitalization than males.
The authors propose that the health disparities between socio-economic groups reflect lower access to primary health care among low-income populations. Approximately 33 to 40 percent of the overall hospitalization rate is estimated to be potentially avoidable for both males and females. The study also looked at other conditions that can be treated in the community, such as diabetes, hypertension and asthma. The combined total in savings by eliminating these hospitalization disparities is estimated to be $400 million.
Due to the complexity of the issue, the authors recommend further research to identify the causes of the observed differences and to clarify how higher hospitalization rates for some conditions are avoidable.
See “Hospitalization Disparities by Socio-Economic Status for Males and Females,” CIHI, October 2010, available at www.cihi.ca. See also “Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada,” CIHI, 2008, available at www.cihi.ca.