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Hospital records lack information about country of birth. This study describes a method for calculating hospitalization rates by the percentage of foreign-born in Census Dissemination Areas (DAs).
Data and methods
Data from the 2006 Census were used to classify DAs by the percentage of the foreign-born population who lived in them. Quintile and tercile thresholds were created to classify DAs as having low to high percentages of foreign-born residents. This information was appended to the 2005/2006 Hospital Morbidity Database via postal codes. Age-sex standardized hospitalization rates were calculated for low to high foreign-born concentration DAs, nationally and subnationally.
Nationally, quintile thresholds had better discriminatory power to detect variations in hospitalization rates by foreign-born concentration, but tercile thresholds produced reliable results at subnational levels. All-cause hospitalization rates were lowest among residents of the high foreign-born concentration terciles. Similar gradients emerged in hospitalization rates for heart disease, diseases of the circulatory system, and mental health conditions. The pattern varied more at the subnational level.
With this approach, administrative data can be used to calculate hospitalization rates by foreign-born concentration.
Administrative data, ecological studies, hospital records, immigration, public health surveillance
By 2031, it is projected that 28% of Canada's population could be foreign-born, up from about 20% in 2006. Understanding patterns of health care use among this growing segment of the population is important for the planning and delivery of services. While evidence suggests better health among the foreign-born compared with people born in Canada, much of that research is based on survey data. Those studies are typically constrained by small sample sizes that limit area-level comparisons. Furthermore, analysis based on survey data may be subject to recall bias or affected by linguistic and cultural barriers. [Full Text]
Gisèle Carrière (1-604-666-5907; firstname.lastname@example.org) is with the Health Analysis Division at Statistics Canada, Vancouver, British Columbia, V6B 6C7. Paul A. Peters and Claudia Sanmartin are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6.
Why is this study important?
- A growing percentage of the Canadian population is foreign-born.
- Understanding the health and health services use patterns of this population is increasingly important.
- Administrative health data typically do not contain information about country of birth.
What is already known on this subject?
- In the absence of individual-level information, ecological methods have been applied to understand patterns of hospital use among areas having greater or lesser percentages of subpopulations.
What this study adds?
- Hospital records that lack information on country of birth can be analysed with aggregate census data to compare hospitalization rates for areas with greater or lesser percentages of foreign-born residents.
- Hospitalization rates tend to be lowest among residents of areas with a high percentage of foreign-born residents.
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