266128 Health Transportation Shortage Index (HTSI): A new measure of child health access

Monday, October 29, 2012

Roy Grant, MA , Medical Affairs, Children's Health Fund, New York, NY
Delaney Gracy, MD , Children's Health Fund, New York, NY
Stephen Borders, PhD , Community Research Institute, Grand Valley State University, Grand Rapids, MI
Dennis Johnson, MPA , The Children's Health Fund, New York, NY
Most discussions of barriers to child healthcare access focus on the availability of insurance. Other factors pose additional barriers, including health professional shortages and inadequate public transportation. In areas with limited health professionals necessitate longer distances to obtain care. Children's Health Fund (CHF) developed a new tool, the Health Professional Shortage Index (HTSI) to identify communities where transportation shortages contribute to difficulty accessing healthcare. The HTSI is based primarily on a nationally representative 2006 survey conducted for CHF that examined transportation resources and healthcare access. These data were supplemented by a 2010 survey of 11 Mississippi Delta counties. The results were validated against demographically similar areas in Texas using Geographic Information System (GIS)-based analysis of hospital discharge data for ambulatory care sensitive condition (ACSC)-related emergency department utilization. With effective primary care, emergency department use and inpatient stays for ACSCs should be unnecessary. The HTSI serves as a guide in assessing important factors associated with transportation barriers to child healthcare access. The HTSI factors are: 1) population, scored by USDA area standards as a proxy for ruralness and travel distance; 2) poverty as a proxy for automobile ownership; 3) health care provider workforce availability (Health Professional Shortage Areas); and 4) public transportation availability. Points are assigned for each factor where higher scores indicate greater risk for transportation barriers to child healthcare access. This new planning tool facilitates the targeting of communities for additional transportation resources and/or improved coordination between the healthcare and transportation sectors to facilitate child health access.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Discuss the impacts transportation barriers have on children's access to primary health care services. Identify areas and populations at the greatest risk for transportation barriers to primary health care services using GIS. Develop potential policy to to address transportation barriers to children's primary health care services.

Keywords: Children's Health, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 15 years' of public health experience and have been deeply involved in the project for the past three years.
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.