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Am J Prev Med. 2016 Oct;51(4):493-501. doi: 10.1016/j.amepre.2016.05.005. Epub 2016 Jun 30.

Ambulatory Care-Sensitive Condition Hospitalizations Among Medicare Beneficiaries.

Author information

1
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC.
2
South Carolina Rural Health Research Center, University of South Carolina, Columbia, South Carolina; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina;. Electronic address: jmeberth@mailbox.sc.edu.
3
South Carolina Rural Health Research Center, University of South Carolina, Columbia, South Carolina; Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina.

Abstract

INTRODUCTION:

This study examined the association between the distribution of primary care physicians and Medicare beneficiaries' ambulatory care sensitive condition hospitalizations using both statistical and spatial analyses.

METHODS:

Data from the 2014 County Health Rankings, 2013-2014 Area Resource File, and the 2014 Food Environment Atlas Data File were integrated to perform county-level ordinary least squares and geographically weighted regression. Analyses were conducted in late 2015.

RESULTS:

Primary care physician density was found to be negatively associated with Medicare beneficiaries' ambulatory care sensitive condition hospitalization rate in both ordinary least squares (β=-5.88, p=0.0037) and geographically weighted regression models (37.08% of all counties), with the latter model finding significant relationships in the South and Northeast.

CONCLUSIONS:

Preventable hospitalizations are high in areas of the U.S. that have low primary care physician density and other healthcare resources, large non-white populations, high levels of area deprivation, and rural designations. Using geospatial techniques helped document areas of greatest concern for potential intervention. Future research needs to account for these regional differences and target surveillance accordingly.

PMID:
27374209
DOI:
10.1016/j.amepre.2016.05.005
[Indexed for MEDLINE]

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