Access to primary care continues to be an important healthcare issue with significant economic ramifications. The unattended medical conditions of individuals without access to primary/preventive healthcare result in more severe episodes, leading to the use of expensive treatment options for illnesses that could have been managed on an outpatient basis. The hospitalization rate for these illnesses, known as Ambulatory Care Sensitive (ACS) conditions, is used as a proxy to assess performance of outpatient delivery systems, high rates indicating inadequate/inaccessible primary care services. Using Small Area Variation Analysis method and1995-1997 hospital discharge data, this study analyzed geographic variation of hospitalizations for ACS conditions for non-elderly adult (<65) and pediatric admissions in NJ. Rates were computed for all counties and zip-codes, age-adjusted and expressed as admissions per 1000 population. NJ counties and zip codes with highest rates for total and individual ACS conditions and most barriers to access primary healthcare were identified. Regression models determined association of area’s socioeconomic factors with admission rates. Poverty was found as the strongest predictor of high ACS rates. 1997 rates showed significant decrease from1995. Focus groups of consumers/providers in problematic areas investigated local barriers deeper and recommended solutions. The findings will help establish regional and local health priorities for planning, prevention, and resource allocation purposes, and design of a delivery system that provides easy access to primary care for the medically indigent communities, saving unnecessary cost of avoidable hospitalizations. This two-year study, funded by a grant from the Robert Wood Johnson Foundation, completed in 2000.
Learning Objectives: At the conclusion of the session, the participant will be able to:
Keywords: Health Care Utilization, Primary Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.