Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111448

Rachel Westheimer Vojvodic, MPH, Charles E. Begley, PhD, Munseok Seo, MPH, and Keith D. Burau, PhD. School of Public Health, The University of Texas Health Science Center at Houston, 1200 Herman Pressler, Houston, TX 77030, 713-500-9179, charles.e.begley@uth.tmc.edu

Objectives: The study applies the NYU ED Algorithm to ED visits of Houston hospitals to identify areas with possible primary care access problems. To evaluate the applicability of the Algorithm as an access indicator, we examine the correlation at the zip code level of high rates of primary care-sensitive visits and other indicators of medical under-service. Methods: We obtained ED visit data from safety net hospitals in Houston. We applied the ED Algorithm to the data to estimate the percentage of visits that were primary care-sensitive, i.e., nonemergent, emergent-primary care treatable, emergent-ED care needed-preventable/avoidable, or non-primary care-sensitive, i.e., emergent-ED care needed-not preventable/avoidable. We also identified at the zip code level the location of community clinics and four measures of medical underservice used by the federal government. We analyzed the relationship between clinics, medical underservice, and PCS ED visits. Results: The distribution of PCS ED visits and the other indicators suggests that access problems probably exist in inner-city and suburban areas of the city, and that PCS ED visits are highly correlated with some but not all of the other access indicators. Conclusions: The NYU ED Algorithm is a valid measure of possible primary care access problems. Its moderate correlation with other access measures suggests that it should be treated cautiously and best viewed as an indicator of access problems rather than a definitive measure. The combination of this indicator with others can be used to monitor and evaluate local initiatives designed to expand care and coverage to the medically underserved.

Learning Objectives:

• Describe the three types of ED visits used by the NYU Algorithm that make up primary care sensitive visits.
• List the four measures of medical underservice used by the federal government.
• Identify measures used to locate primary care access problems.

Keywords: Safety Net, Access to Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation