The 130th Annual Meeting of APHA

Abstract #49309

Chris L. Day, MPH, Public Health Foundation, 1220 L. Street, N.W. Suite 350, Washington, DC 20005, 202-898-5600 ext 3017, cday@phf.org

Pneumonia is a classic example of an ambulatory care sensitive condition (ACSC). ACSCs are medical conditions that should not generally require hospitalization if adequate, appropriate, and timely primary care is available and accessible. Hospitalizations due to these conditions generally reflect inadequate access to primary or ambulatory care resulting in the use of ACSC as an indicator of access to primary care. However, barriers to primary care access may also include personal behavior, geographic location, and insurance coverage.

In a cross sectional study conducted on Kentucky's hospital population, pneumonia, as manifest by its prevalence, resulted in the third highest number of hospitalizations (21,603) behind DRGs 391 (normal newborns) and 373 (vaginal delivery without complications). Rural underserved areas, specifically those in eastern Kentucky experienced higher rates of pneumonia hospitalization than urban areas. Approximately 40% of the variation in the hospitalization rate could be explained by the number of primary care physicians per area development district (ADD), a partnership of local units of government organized into regions. Subsequently, the ratio of physicians to population per ADD showed a moderate inverse relationship to the hospitalization rate (r=0.-410; P<.05). Therefore, geographic access to primary and ambulatory care plays a significant role in hospitalization for pneumonia.

This study profiles the epidemiological and fiscal burden of pneumonia in Kentucky and examines hospitalization trends focusing on access to primary and ambulatory care. In addition, recommendations about how to reduce the number of hospitalizations through vaccine administration and timely, appropriate primary and ambulatory care are also discussed.

Learning Objectives:

• Describe the epidemiology of pneumonia, specifically pneumococcal pneumonia, in Kentucky
• Articulate the difference between pneumonia and pneumococcal pneumonia including why it is important
• Identify a number of pneuococcal vaccines and discuss vaccine efficacy
• Define ambulatory care sensitive conditions
• Discuss financial, geographic and social barriers to primary and ambulatory care
• List 4 recommendations to reduce the incidence of pneumonia hospitalization in a community

Keywords: Access to Care, Primary Care

Presenting author's disclosure statement:
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.