School of Government and GobLab, Universidad Adolfo Ibanez, Santiago, RM, Chile
Department of Sociology, University of Chicago, Chicago, Illinois, USA.
BMJ Open. 2020 Aug 16;10(8):e034512. doi: 10.1136/bmjopen-2019-034512.
To measure poverty-based disparities in inpatient length of stay for paediatric hospitalisations. In particular, this paper examines the relationship between municipality level poverty rates and length of stay, accounting for individual level characteristics.
We use patient discharge data to conduct a repeated cross-sectional study of the totality of paediatric hospitalisations in 15 regions of Chile, in the years 2011, 2013, 2015 and 2017.
All hospital discharges in 15 regions of Chile.
1 033 222 discharges for children under the age of 15, between 2011 and 2017.
Length of stay (LOS); LOS by type of insurance and type of hospital; hospitalisation rates; municipality-level average LOS.
We find that municipality level poverty rates are a significant predictor of LOS, even after controlling for individual and area level characteristics, including type of insurance. Children from municipalities in the poorest quintile have a LOS that is 14% shorter as compared with children from municipalities in the richest quintile. This relationship is stronger for publicly insured children: the decrease in LOS associated with the same poverty change is of 22%.
This paper shows that there is an association between municipality-level poverty rates and length of stay for paediatric hospitalisations in Chile. For the vast majority of the sample, and after controlling for individual level characteristics, an increase in the municipality level poverty rate is associated with a decrease in the length of stay. Further, there is a non-linearity in the relationship, where at the highest poverty rates, poverty and LOS are positively associated. These findings are robust after controlling for type of hospital (public vs private), type of insurance (public vs private), type of diagnosis, as well as year and region fixed effects.
衡量儿科住院患者因贫困导致的住院时间差异。具体而言，本文考察了市县级贫困率与住院时间之间的关系，同时考虑了个体特征。
我们使用患者出院数据，对智利 15 个地区的所有儿科住院患者进行了一个重复的横断面研究，研究时间为 2011 年、2013 年、2015 年和 2017 年。
智利 15 个地区的所有医院出院患者。
2011 年至 2017 年间，15 个地区共有 1033222 名 15 岁以下儿童出院。
住院时间（LOS）；不同保险类型和不同医院类型的 LOS；住院率；市县级平均 LOS。
我们发现，即使在控制了个体和地区特征，包括保险类型后，市县级贫困率仍是 LOS 的一个重要预测因素。来自最贫困五分之一市县级的儿童的 LOS 比来自最富裕五分之一市县级的儿童短 14%。对于公共保险的儿童，这种关系更强：与相同贫困变化相关的 LOS 减少了 22%。
本文表明，智利市县级贫困率与儿科住院时间之间存在关联。对于绝大多数样本，并且在控制了个体特征后，市县级贫困率的增加与住院时间的减少相关。此外，这种关系是非线性的，在最高贫困率下，贫困和 LOS 呈正相关。在控制了医院类型（公立与私立）、保险类型（公立与私立）、诊断类型以及年份和地区固定效应后，这些发现仍然稳健。
