Geographical accessibility and Kentucky's heart-related hospital services
Geographical accessibility and Kentucky's heart-related hospital services
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DOI：
10.1016/j.apgeog.2007.07.004
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发表时间：
2007-10-01
影响因子：
4.9
通讯作者：
Barcus, Holly R.
中科院分区：
文献类型：
--
作者：
Hare, Timothy S.;Barcus, Holly R.
心血管疾病（cvd）是导致美国人死亡的主要原因。死亡率在空间上和人口上各不相同，不仅受到患者个体特征的影响，而且受到获得医院服务和设施的程度的影响。2000年，肯塔基州因心脏原因死亡的人数在全国排名第三。本文的目的是评估地理可及性和服务利用相关的门诊敏感心血管疾病在肯塔基州。本研究利用肯塔基州医院出院数据库评估服务利用率，并使用压缩死亡率文件检查与心血管疾病相关的死亡率。对服务使用的地理分布和到医院的旅行时间进行空间统计比较，有助于评估可及性与健康之间的关系。我们的研究结果表明，利用率和死亡率的分布具有地理差异。生活在农村地区的人们需要走更远的路去就医；居住在距离卫生设施45分钟以上的人口更有可能在社会和经济上处于边缘地位。高医院使用率的空间聚类发生在可达性较低的地区。(C) 2007 Elsevier Ltd.版权所有。
Cardiovascular diseases (CVDs) are a leading cause of mortality in the US. Rates of mortality vary spatially and demographically, influenced not only by individual patient characteristics but also by levels of accessibility to hospital services and facilities. In 2000, Kentucky ranked third in the nation for heart-related deaths. The purpose of this paper is to assess geographical accessibility and service utilization related to ambulatory care sensitive CVDs in Kentucky. This study utilizes the Kentucky Hospital Discharge Database to evaluate service utilization and the Compressed Mortality File to examine mortality related to CVDs. A spatial statistical comparison of the geographical distribution of service usage and travel time to hospitals assists in assessing the relationship between accessibility and health. Our findings suggest that the distribution of utilization and mortality is geographically variable. People living in rural areas travel further to services; populations residing more than 45 min from health facilities are more likely to be socially and economically marginalized. Spatial clustering of high rates of hospital utilization occurs in areas with lower accessibility. (C) 2007 Elsevier Ltd. All rights reserved.