Emergency room use and access to primary care: Evidence from Houston, Texas
Emergency room use and access to primary care: Evidence from Houston, Texas
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DOI：
10.1353/hpu.2006.0098
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发表时间：
2006-08-01
影响因子：
1.4
通讯作者：
Burau, Keith
中科院分区：
文献类型：
--
作者：
Begley, Charles E.;Vojvodic, Rachel Westheimer;Burau, Keith
为了应对不断增加的未参保人数，全国各地的社区正在采取各种策略来扩大当地的医疗保健安全网。建议评估有效措施的一项措施是初级保健相关的急诊科 (ED) 就诊。在本文中，我们通过检查该指标与其他医疗服务不足指标的相关性，评估了该指标作为访问指标的适用性。我们从德克萨斯州休斯顿的安全网医院获得了急诊就诊数据，并应用纽约大学急诊就诊算法来估计与初级保健相关的就诊率。然后，我们在邮政编码层面检查了每 1,000 人中与初级保健相关的急诊就诊次数与联邦政府的医疗服务不足指数 (IMU)、贫困率和无保险率的相关性。发现与初级保健相关的急诊就诊与 IMU 相关性较弱，而与无保险和贫困率强相关。这些发现表明，该指标与其他获取措施的结合可用于监测和评估旨在扩大医疗服务不足人群的护理和覆盖范围的当地举措。
To cope with the rising number of uninsured, communities around the country are pursuing a variety of strategies to expand local health care safety nets. One measure that has been suggested to evaluate what is working is primary care-related emergency department (ED) visits. In this paper, we evaluate the applicability of this measure as an access indicator by examining its correlation with other indicators of medical under-service.We obtained ED visit data from safety net hospitals in Houston, Texas and applied the New York University ED Algorithm to estimate the rate of visits that were primary care-related. We then examined at the ZIP code level the correlation of primary care-related ED visits per 1,000 population with the federal government's Index of Medical Underservice (IMU), the poverty rate, and the uninsurance rate.Primary care-related ED visits were found to be weakly correlated with the IMU and strongly correlated with the rate of uninsurance and poverty. These findings suggest that the combination of this indicator with other measures of access could be used to monitor and evaluate local initiatives designed to expand care and coverage to the medically underserved.