226922 A social deprivation measure at the Primary Care Service Area (PCSA) level-predictive of health care access and need

Wednesday, November 10, 2010 : 12:50 PM - 1:10 PM

Danielle Butler, MBBS, MPH , Australian Primary Health Care Research Institute, Australia National University, Canberra, Australia
Stephen Petterson, PhD , The Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians, Washington, DC
Robert L. Phillips, MD, MSPH , The Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians, Washington, DC
Title: A social deprivation measure at the Primary Care Service Area (PCSA) level-predictive of health care access and need

Objective: To examine the role of a social deprivation measure at the PCSA level and its relationship with measures of health care access and need.

Data Sources: Socio-demographic data from Dartmouth Atlas aggregated at PCSA level, derived from 2000 US Census; HCUP data for ambulatory care sensitive hospitalisations (ACSH); AMA Masterfile for physician data; Current Population Survey for insurance coverage and rurality measures sourced from.

Study Design: Variables for social deprivation measure selected on basis of review of the literature and international experience. Factor analysis of population weighted data used to identify factors based on an eigenvalue greater than 1. Varimax rotation applied. A single measure for each PCSA was created by forcing analysis to a factor of one. To validate this measure, a pair wise correlation analysis was conducted between our composite social deprivation measure, and measures of health care access (insurance coverage and ACSH), workforce and rurality.

Principle findings: Three factors were identified describing socio-cultural elements, socioeconomic status and measures of community disorganisation. Our composite measure had a strong positive association with uninsurance (0.62), and ACSH (0.38), and a negative association with primary care (-0.10) and family physician rates (-0.22), and rurality (-0.16).

Conclusions: This study demonstrates the predictive value of a combined social deprivation measures at the rationale service area level of PCSA. This has potential application for primary health care resource allocation for more equitable distribution.

Learning Areas:
Advocacy for health and health education
Biostatistics, economics
Epidemiology
Provision of health care to the public
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe how to measure social disadvantage at a primary care service area level. Discuss the policy implications of different measures of health care access.

Keywords: Access, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a qualified and practising family physician, have obtained a masters in Public Health and have completed this research under the supervision of a qualified sociologist/statistician with extensive experience in primary health care policy and large dataset analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5190.0: Statistical Applications in Community Health and Epidemiology