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

Abstract #113673

Zahid Ansari, MBBS, MPH, Health Surveillance and Evaluation Section, Rural and Regional Health and Aged Care Services, Victoria State Government Department of Human Services, 18/120 Spencer Street, Melbourne, Australia, James Laditka, DA, PhD, Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, 800 Sumter Street, HESC, Columbia, SC 29208, (803)777-6852, jladitka@gwm.sc.edu, and Sarah Laditka, PhD, Arnold School of Public Health, Department of Health Services Policy and Management, University of South Carolina, 800 Sumter Street, HESC, Columbia, SC 29208.

Hospitalization may often be avoidable for Ambulatory Care Sensitive Conditions (ACSCs) when accessible health care provides preventive care, disease management, or timely interventions. However, empirical research examining the relationship between hospitalization for ACSCs (ACSH) and access to medical care has produced conflicting results. We examine whether ACSH is associated with access to medical care. Data were from 32 health services areas of Victoria, a state in Southeastern Australia with a population of 4.4 million. Hospital discharge data were obtained from the Victorian Admitted Episodes Dataset, 1999-2000, with data from all public and private hospitals. We calculated the standardized ACSH rate for each area for individuals age 18 and over. We used a representative survey of Victorians to measure reported access to medical care, ACSC prevalence, propensity to seek care, illness burden, social determinants of health services use, and selected risk factors. Regression analysis compared self-rated access with ACSH rates. Associations among self-rated access to medical care, ACSH, and physician supply were also examined. Communities with better access to medical care had lower ACSH rates. The association was independent of ACSC prevalence, propensity to seek health care, and illness burden. Physician supply was positively associated with self-rated access, and negatively associated with ACSH. Results support use of ACSH as an indicator of health care access. ACSH can assess the impact of programs and policies designed to improve health care accessibility. Health care planners can use ACSH to develop targeted interventions for reducing both access barriers and the occurrence of avoidable morbidity.

Learning Objectives:

• 3. Articulate associations between self-rated access to health care and hospitalization for ambulatory care sensitive conditions (ACSH).
  7. Assess the validity of the ACSH indicator as a measure of access to health care.
  11. Discuss public health opportunities for notably reducing avoidable morbidity associated with ambulatory care sensitive conditions.

Keywords: Access to Health Care, Ambulatory 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