Original Articles
Vol. 6 No. 1 (2011)
https://doi.org/10.4081/gh.2011.153

Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong

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Received: 18 December 2014
Published: 1 November 2011
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geographical variation, stroke, incidence, case-fatality, Hong Kong.

Authors

Pui Hing Chau
phchau@graduate.hku.hk
Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.
Jean Woo
Faculty of Social Sciences, The University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
William B. Goggins
Division of Biostatistics, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Moses Wong
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Kam Che Chan
Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.
Suzanne C. Ho
School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rates by stroke subtype among the population aged 35 years and above in 1999-2007. Multilevel models were used to examine the spatio-temporal variations. Ischemic stroke incidence was found to decrease among those aged above 55 years, while hemorrhagic stroke incidence increased. Ischemic stroke case-fatality was found to decrease but hemorrhagic stroke case-fatality remained stable. For both subtypes, there were significant variations in stroke incidence and case-fatality across the districts of residence, but insignificant variations across HA service clusters. Only variations in ischemic stroke incidence and hemorrhagic stroke case-fatality at the district level could be partly explained by district-level SES. Identification of districts with higher risk for stroke incidence and case-fatality would help to formulate enhanced preventive measures. Future studies are needed to identify factors that contribute to the geographical variations.

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Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong. (2011). Geospatial Health, 6(1), 13-20. https://doi.org/10.4081/gh.2011.153

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