The nature of increased hospital use in poor neighbourhoods: findings from a Canadian inner city.

The relationship between socioeconomic factors and hospital use is not well understood in the Canadian context. We used the 1991 Canada census and 1990-92 Ontario hospital discharge abstracts for residents of southeast Toronto to calculate crude and age-sex adjusted rates of hospital admission, bed days, and costs by quintile of low-income households. Population-based rates of admission to hospital, bed days and costs were all significantly related to census tract income (p < 0.01 for males and females). The number of admissions per person admitted was significantly associated with census tract income (p < 0.01 for males and females), but length of stay and resource intensity weight were not. Hospital costs were 50.0% higher for the poorest quintile of neighbourhoods than for the wealthiest and 35.8% higher than for the middle-income quintile. Poor urban neighbourhoods may require more resources than previously anticipated, related to higher hospital admission and readmission rates.