Ambulatory Care-Sensitive Condition Hospitalizations Among Medicare Beneficiaries

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• 作者：Yu-Hsiu Lin ; PhD¹ ; Jan M. Eberth ; PhD² ; ³ ; ⁴ ; ^{jmeberth@mailbox.sc.edu" class="auth_mail" title="E-mail the corresponding author} ; Janice C. Probst ; PhD² ; ⁵
• 刊名：American Journal of Preventive Medicine
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：51
• 期：4
• 页码：493-501
• 全文大小：2873 K

文摘

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.