Racial Disparities In Geographic Access To Primary Care In Philadelphia
Racial Disparities In Geographic Access To Primary Care In Philadelphia
复制标题
DOI：
10.1377/hlthaff.2015.1612
复制
发表时间：
2016-08-01
期刊：
影响因子：
9.7
通讯作者：
Grande, David
中科院分区：
文献类型：
--
作者：
Brown, Elizabeth J.;Polsky, Daniel;Grande, David
初级保健通常被认为是改善健康结果的途径，并且可以更有效地利用医疗保健资源。由于初级保健至关重要，因此充分获得初级保健是卫生政策的一个重要优先事项。在人口稠密的城市地区，人们对跨社区初级保健提供者的空间获取知之甚少。我们研究了宾夕法尼亚州费城初级保健获取的空间差异。我们计算了每个人口普查区每个初级保健提供者的成年人比例，并根据每个普查区周围预先指定的驾驶时间纳入了缓冲区。我们发现平均比率为 1,073；各人口普查区初级保健提供者的供应情况差异很大，从 105 人到 10,321 人不等。我们确定了费城的六个地区，与城市其他地区相比，初级保健的空间可达性要低得多。在对社会人口统计和保险特征进行调整后，非裔美国人比例较高的人口普查区域处于交通不便地区的几率是非裔美国人比例较低的地区的二十八倍。
Primary care is often thought of as the gateway to improved health outcomes and can lead to more efficient use of health care resources. Because of primary care's cardinal importance, adequate access is an important health policy priority. In densely populated urban areas, spatial access to primary care providers across neighborhoods is poorly understood. We examined spatial variation in primary care access in Philadelphia, Pennsylvania. We calculated ratios of adults per primary care provider for each census tract and included buffer zones based on prespecified drive times around each tract. We found that the average ratio was 1,073; the supply of primary care providers varied widely across census tracts, ranging from 105 to 10,321. We identified six areas of Philadelphia that have much lower spatial accessibility to primary care relative to the rest of the city. After adjustment for sociodemographic and insurance characteristics, the odds of being in a low-access area were twenty-eight times greater for census tracts with a high proportion of African Americans than in tracts with a low proportion of African Americans.