Socioeconomic differences in childhood hospital inpatient service utilisation and costs: prospective cohort study
Child; Female; Humans; infant; Male; England; Prospective Studies; Socioeconomic Factors; Health Services Research; Social Class; Preschool; Non-U.S. Gov't; Research Support; infant; Newborn; Epidemiologic Methods; Length of Stay/statistics & numerical data; Hospital Costs/statistics & numerical data; Hospitalized/classification/statistics & numerical data; Hospitals/utilization
STUDY OBJECTIVE: To examine the association between socioeconomic position at the time of birth and the use and cost of hospital inpatient services during the first 10 years of life. DESIGN: Analysis of a database of linked birth registrations, hospital records, and death certificates. Associations between the social class of the head of household and hospital inpatient service utilisation and costs during the first 10 years of life were analysed using multilevel multiple regression modelling. PARTICIPANTS AND SETTING: All 117 212 children born to women who both lived and delivered in hospital in Oxfordshire or West Berkshire, southern England, during the period 1 January 1979 to 31 December 1988. MAIN RESULTS: The study showed that children born into social classes II, III-NM, III-M, IV, and V were more likely to be admitted to hospital, spend longer in hospital overall, and generate greater hospital costs than children born into social class I. The adjusted effect regarding hospital inpatient admissions, days, and costs was 1.27 (95% CI: 1.26, 1.27), 1.20 (1.19, 1.21), and 1.50 (1.49, 1.53), respectively, for children born into social class V when compared with children born into social class I. The impact of social class on hospital inpatient admissions, days, and costs was most acutely felt during years 3-10 of life as compared with the first two years of life. CONCLUSIONS: Health service decision makers need to be alert to the adverse sequelae that might result from socioeconomic disadvantage when planning health services for children. Particular attention should be paid to targeting deprived populations with prevention interventions that are known to be effective.
2005
Petrou S; Kupek E
Journal Of Epidemiology And Community Health
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/jech.2004.025395" target="_blank" rel="noreferrer">10.1136/jech.2004.025395</a>
Roads, railways, and childhood cancers
Non-U.S. Gov't; PedPal Lit; Air Pollutants; Environmental/toxicity Automobiles Butadienes/toxicity Carbon Monoxide/toxicity Child Child; Preschool Environmental Exposure/adverse effects Female Great Britain/epidemiology Humans Infant Male Neoplasms/chemically induced/epidemiology Railroads Research Support
Study OBJECTIVES: To locate geographical sources of engine exhaust emissions in Great Britain and to link them with the birth addresses of children dying from cancer. To estimate the cancer initiating roles of nearby roads and railways and to measure effective ranges. DESIGN: Birth and death addresses of all children born between 1955 and 1980 in Great Britain, and dying from leukaemia or other cancer during those years, were linked to locations of railway stations, bus stations, ferry terminals, railways, roads, canals, and rivers. Nearest distances to births and deaths were measured, and migration data relating to children who had moved house were analysed. Excesses of close to hazard birth addresses, compared with close to hazard death addresses, indicate a high prenatal or early postnatal risk of cancer initiation. SETTING AND SUBJECTS: Child cancer birth and death addresses and their map references were extracted from an earlier inquiry. Map references of putative hazards were downloaded from the Ordnance Survey national digital map of Great Britain. These data are recorded to a precision of one metre and have ground accuracies around 20 metres. MAIN RESULTS: Significant birth excesses were found within short distances of bus stations, railway stations, ferries, railways, and A,B class roads, with a relative risk of 2.1 within 100 m, tapering to neutral after 3.0 km. About 24% of child cancers were attributable to these joint birth proximities. Roads exerted the major effect. CONCLUSIONS: Child cancer initiations are strongly determined by prenatal or early postnatal exposures to engine exhaust gases, probably through maternal inhalation and accumulation of carcinogens over many months. The main active substance is probably 1,3-butadiene.
2006
Knox EG
Journal Of Epidemiology And Community Health
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/jech.2005.042036" target="_blank" rel="noreferrer">10.1136/jech.2005.042036</a>
Alternatives to randomisation in the evaluation of public health interventions: design challenges and solutions
Bonell CP; Hargreaves J; Cousens S; Ross D; Hayes R; Petticrew M; Kirkwood BR
Journal Of Epidemiology And Community Health
2011
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/jech.2008.082602" target="_blank" rel="noreferrer">10.1136/jech.2008.082602</a>