Physician Visits, Hospitalizations, and Socioeconomic Status: Ambulatory Care Sensitive Conditions in a Canadian Setting

Roos, Leslie L.; Walld, Randy; Uhanova, Julia; Bond, Ruth

doi:10.1111/j.1475-6773.2005.00407.x

Cited by 212 publications

(207 citation statements)

References 50 publications

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“…Our finding that very high neighborhood poverty is associated with higher preventable hospitalization rates builds on Billings and colleagues' analysis of New York City hospitalizations 20 years ago (1982 to 1993), although they found the disparity between low-income and high-income neighborhoods increased during that time period. 1 Studies in countries with universal health coverage have also found that preventable hospitalizations are higher for low-income populations and residents living in lowincome neighborhoods, 37,38 suggesting that quality and availability of primary care may be an issue for people living in high poverty neighborhoods regardless of insurance status. In New York City, every very high poverty neighborhood also qualifies as a federally designed Health Professional Shortage Area or Medically Underserved Area in whole or in part, indicating that these areas or populations have a shortage of primary medical care.…”

Section: Discussionmentioning

confidence: 99%

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Bocour

Tria

2016

J Urban Health

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Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators . The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with G10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

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Section: Discussionmentioning

confidence: 99%

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Bocour

Tria

2016

J Urban Health

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“…Sabe-se que piores condições socioeconô-micas afetam o acesso aos serviços de saúde, modificam o padrão de utilização desses, dando preferência ao uso de serviços de emergência, prejudicam a adesão ao tratamento (falta de dinheiro para comprar medicamentos), dificultam a adoção de hábitos saudáveis e o amparo da rede de suporte social. Estudos prévios enfatizaram a importância desses fatores e apontam para maiores taxas de ICSAP entre a população de piores condições socioeconômicas 7,8,20 .…”

Section: Discussionunclassified

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Pazó

Frauches²,

Maria

et al. 2014

Cad. Saúde Pública

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O objetivo deste estudo foi investigar a associação entre a organização dos serviços de saúde e as taxas de internações hospitalares por condições sensíveis à atenção primária após ajuste para variáveis socioeconômicas e demográficas no contexto dos municípios do Espírito Santo, Brasil. Estudo ecológico das internações do Sistema Único de Saúde (SUS) com as variáveis: internações hospitalares por condições sensíveis à atenção primária, porte municipal, indicadores demográficos, socioeconômicos, organização e indicadores de desempenho dos serviços de saúde. Realizou-se análise multivariável por regressão de Poisson com ajuste robusto da variância. Foram ajustados modelos para a população total e por faixas etárias. Ordenaram-se as variáveis explicativas segundo modelo hierarquizado. Houve associação a risco de internações hospitalares por condições sensíveis à atenção primária com o percentual de analfabetismo (RR: 1,08-1,17), proporção de leitos SUS (RR: 1,09-1,12), urbanização (RR: 1,02-1,03), proporção de negros (RR: 0,97-0,98) e cobertura de plano de saúde (RR: 0,97-0,98). Há determinantes das internações hospitalares por condições sensíveis à atenção primária que implicam no padrão de utilização dos serviços e estão fora do escopo da atenção primária.

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“…However, the reducing number of hospitalizations can also be a result of the insufficient number of beds and barriers in hospital access 27 .…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, when health care is performed by services who do not work with the FHS, there is significant increase in hospitalization rates for ACSC 4 . The longitudinal aspect of care provided by FHS professionals and the connection between users and workers contribute with the increasing resoluteness and with the reduction of hospitalizations 13,27 .…”

Section: Discussionmentioning

confidence: 99%

Hospitalization due to conditions sensitive to primary care and expansion of the Family Health Program in Brazil: an ecological study

Ceccon

Meneghel

Viecili

2014

Rev. bras. epidemiol.

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ABSTRACT:Objective: To evaluate the relationship between hospitalization due to conditions that are sensitive to primary care and the population coverage by the Family Health Strategy (ESF) Units of the Brazilian Federation Units in the last decade. Methods: This is an ecological study that investigated preventable hospitalizations and coverage of primary health care in Brazil in the historic series from 1998 to 2006. Statistical analysis was performed using the Pearson correlation test and simple linear regression. Results: In the studied period, we found an association between population coverage and reduced ESF admissions for primary care sensitive conditions in Brazil (β = -28.78, p ≤ 0.01), which occurred in 38.4% of the Federation Units. Conclusion: There was a positive relationship between the expansion of ESF coverage and a decline in hospitalizations for ACSC in the country. The findings of this study help to evaluate the ESF and primary care in Brazil.

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Physician Visits, Hospitalizations, and Socioeconomic Status: Ambulatory Care Sensitive Conditions in a Canadian Setting

Abstract: In the Canadian universal health care plan, the poor have reasonable access to ambulatory care for ACS conditions. Ambulatory care may be more effective in preventing hospitalizations among relatively affluent individuals than among the less well off.

Cited by 212 publications

References 50 publications

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Hospitalization due to conditions sensitive to primary care and expansion of the Family Health Program in Brazil: an ecological study

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