Experiment To Decrease Neighborhood Poverty Had Limited Effects On Emergency Department Use
Experiment To Decrease Neighborhood Poverty Had Limited Effects On Emergency Department Use
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DOI：
10.1377/hlthaff.2019.00452
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发表时间：
2019-09-01
期刊：
影响因子：
9.7
通讯作者：
Herring, Bradley
中科院分区：
文献类型：
--
作者：
Pollack, Craig E.;Du, Shawn;Herring, Bradley
社区环境越来越多地被认为会影响急诊科（艾德）的使用。然而，由于人们根据一系列因素决定住在哪里，因此要确定生活在较高贫困社区对艾德就诊率增加的因果影响可能具有挑战性。我们的研究利用了移动到公平住房示范计划的机会，这是一项始于1994年的社会实验，随机分配了大约4,600个接受联邦住房援助的家庭到不同的社区条件。我们将四个州的项目参与者与平均12年的艾德使用管理数据（随机化后长达21年）联系起来。与我们的预期相反，我们没有发现一个一贯的显着联系邻里贫困和整体艾德使用在此后续期间。这一结果在成人和随机化时为儿童的人以及各种分类的艾德访视中均观察到。这些发现可以帮助指导未来的研究，以澄清邻里环境和医疗保健使用之间的关系。
Neighborhood environments are increasingly thought to affect emergency department (ED) use. However, because people decide where to live based on a range of factors, it can be challenging to identify the causal impact of living in higher-poverty neighborhoods on increased rates of ED visits. Our study leveraged the Moving to Opportunity for Fair Housing Demonstration Program, a social experiment beginning in 1994 that randomly assigned approximately 4,600 households that received federal housing assistance to different neighborhood conditions. We linked program participants in four states with an average of twelve years of administrative data on ED use (up to twenty-one years after randomization). Contrary to our expectations, we did not find a consistently significant connection between neighborhood poverty and overall ED use during this follow-up period. This result was observed for both adults and people who were children at the time of randomization, as well as for various classifications of ED visits. The findings can help direct future research that seeks to clarify the relationship between neighborhood environments and health care use.