Travel Distance to HIV Medical Care: A Geographic Analysis of Weighted Survey Data from the Medical Monitoring Project in Philadelphia, PA
Travel Distance to HIV Medical Care: A Geographic Analysis of Weighted Survey Data from the Medical Monitoring Project in Philadelphia, PA
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DOI：
10.1007/s10461-013-0597-7
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发表时间：
2014-04-01
影响因子：
4.4
通讯作者：
Brady, K. A.
中科院分区：
文献类型：
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作者：
Eberhart, M. G.;Voytek, C. D.;Brady, K. A.
关于患者在哪里获得艾滋病毒护理的决定尚不清楚。本分析的目的是调查在费城接受护理的人员前往护理的出行距离的差异。采用多阶段抽样设计确定了 400 名潜在参与者。 65 % (260/400) 同意接受采访。参与者被问及有关医疗保健、支持服务和地理位置的问题。计算居住地和护理地点之间的距离。 46.3% 的人出行距离最近的设施超过三英里。没有保险的人比有公共保险的人（3.3 英里，2.9-3.6）行驶得更远（6.9 英里，95% CI 3.9-9.8）。在多变量分析中，没有保险 (20/260) 与距离增加相关 (p = 0.0005)，西班牙裔与距离减少相关 (p = 0.0462)。没有保险的人出行距离更远，但仅凭保险状况并不能解释就医距离的变化。在费城，西班牙裔人口以及他们最容易接触到的服务提供者在空间上受到限制。
Decisions regarding where patients access HIV care are not well understood. The purpose of this analysis was to examine differences in travel distance to care among persons receiving care in Philadelphia. A multi-stage sampling design was utilized to identify 400 potential participants. 65 % (260/400) agreed to be interviewed. Participants were asked questions about medical care, supportive services, and geographic location. Distances were calculated between residence and care location. 46.3 % travelled more than three miles beyond the nearest facility. Uninsured travelled further (6.9 miles, 95 % CI 3.9-9.8) than persons with public insurance (3.3 miles, 2.9-3.6). In multivariate analyses, no insurance (20/260) was associated with increased distance (p = 0.0005) and Hispanic ethnicity was associated with decreased distance (p = 0.0462). Persons without insurance travel further but insurance status alone does not explain the variability in distance travelled to care. In Philadelphia, Hispanic populations, and providers that may be most accessible to them, are spatially contained.