Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: A population-based data linkage study

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    Abstract

    Objectives: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non- Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. Design: Prospective population-based linked data set. Setting and participants: All preterm babies born in Western Australia during 2010 and 2011. Main outcome measures: All-cause hospitalisations and emergency department presentations. Results: There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22). Conclusions: In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.

    Original languageEnglish
    Article numbere013492
    JournalBMJ Open
    Volume7
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2017

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    Information Storage and Retrieval
    Premature Infants
    Population
    Western Australia
    Incidence
    Hospital Emergency Service
    Vulnerable Populations
    Emergencies
    Hospital Departments
    Hospitalization
    Outcome Assessment (Health Care)
    Parturition

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    @article{375fa6099cb84c73a31970ff790233c8,
    title = "Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: A population-based data linkage study",
    abstract = "Objectives: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non- Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. Design: Prospective population-based linked data set. Setting and participants: All preterm babies born in Western Australia during 2010 and 2011. Main outcome measures: All-cause hospitalisations and emergency department presentations. Results: There were 6.9{\%} (4211/61 254) preterm infants, 13.1{\%} (433/3311) Indigenous preterm infants and 6.5{\%} (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95{\%} CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95{\%} CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95{\%} CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95{\%} CI 1.49 to 2.22). Conclusions: In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.",
    author = "Strobel, {Natalie A.} and Sue Peter and McAuley, {Kimberley E.} and McAullay, {Daniel R.} and Rhonda Marriott and Edmond, {Karen M.}",
    year = "2017",
    month = "1",
    day = "1",
    doi = "10.1136/bmjopen-2016-013492",
    language = "English",
    volume = "7",
    journal = "BMJ (Open)",
    issn = "2044-6055",
    publisher = "John Wiley & Sons",
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    TY - JOUR

    T1 - Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age

    T2 - A population-based data linkage study

    AU - Strobel, Natalie A.

    AU - Peter, Sue

    AU - McAuley, Kimberley E.

    AU - McAullay, Daniel R.

    AU - Marriott, Rhonda

    AU - Edmond, Karen M.

    PY - 2017/1/1

    Y1 - 2017/1/1

    N2 - Objectives: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non- Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. Design: Prospective population-based linked data set. Setting and participants: All preterm babies born in Western Australia during 2010 and 2011. Main outcome measures: All-cause hospitalisations and emergency department presentations. Results: There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22). Conclusions: In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.

    AB - Objectives: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non- Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. Design: Prospective population-based linked data set. Setting and participants: All preterm babies born in Western Australia during 2010 and 2011. Main outcome measures: All-cause hospitalisations and emergency department presentations. Results: There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22). Conclusions: In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.

    UR - http://www.scopus.com/inward/record.url?scp=85009771916&partnerID=8YFLogxK

    U2 - 10.1136/bmjopen-2016-013492

    DO - 10.1136/bmjopen-2016-013492

    M3 - Article

    VL - 7

    JO - BMJ (Open)

    JF - BMJ (Open)

    SN - 2044-6055

    IS - 1

    M1 - e013492

    ER -