posted on 2018-06-19, 00:00authored byJamie Fishman, Sara McLafferty, William Galanter
Objective
To examine the contributions of individual‐ and neighborhood‐level spatial access to care to the utilization of emergency departments (EDs) for preventable conditions through implementation of novel local spatial access measures.
Data Sources/Study Setting
Emergency department admissions data are from four HealthLNK member hospitals in Chicago from 2007 to 2011. Primary care physician office and clinic locations were obtained from the American Medical Association and the City of Chicago.
Study Design
Multilevel logit regression was used to model the relationship between individual‐ and neighborhood‐level attributes and preventable ED use.
Data Collection/Extraction Methods
Emergency department admissions data were classified based on the primary diagnosis for each encounter. Spatial access to care indices were generated in ArcGIS, and values were extracted at each ZIP code centroid to match patients' ZIP codes.
Principal Findings
Beyond sociodemographic factors such as gender and race, patients living in medically underserved areas (MUAs) and areas with lower spatial access to primary care clinics had higher odds of preventable ED use.
Conclusions
Preventable ED use can be associated with sociodemographic characteristics, as well as spatial access to primary care services. This study reveals potential for using local measures of spatial accessibility for preventable ED analyses.
History
Publisher Statement
This is the pre-peer reviewed version of the following article:Fishman, J., McLafferty, S. and Galanter, W. Does Spatial Access to Primary Care Affect Emergency Department Utilization for Nonemergent Conditions? Health Services Research. 2018. 53(1): 489-508. which has been published in final form at 10.1111/1475-6773.12617.
Citation
Fishman, J., McLafferty, S. and Galanter, W. Does Spatial Access to Primary Care Affect Emergency Department Utilization for Nonemergent Conditions? Health Services Research. 2018. 53(1): 489-508. 10.1111/1475-6773.12617.