Abstract
Population-based hospitalization rates for preventable conditions are derived for a low-income population in Galveston County, Texas using discharge data from four area hospitals and demographic data from the U.S. Census. Comparisons are made with similar rates for the general populations of two eastern states (Maryland and Massachusetts) and New York City. Results support the hypothesis that low-income persons lack access to primary care, leading to higher rates of hospitalization for preventable conditions. Alternative explanations for differences found are examined.
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Rutstein DD, Berenberg W, Chalmers TC, et al Measuring the quality of medical care: a clinical method.N Engl J Med. 294:582–588. 1976.
Craddick JW. The medical management analysis system.QRB Qual Rev Bull. 5:2–8. 1979.
Newacheck PW. Access to ambulatory care for poor persons.Health Services Res. 23:401–419. 1988.
Howell EM. Low-income persons' access to health care: NMCUES Medicaid data.Public Health Rep. 103:507–514. 1988.
Donabedian A. Evaluating the quality of medical care.Milbank Memorial Fund Quarterly. 44 (Part 2): 166–206. 1966.
Ayanian JZ, Kohler BA, Toshi A, et al. The relation between health insurance coverage and clinical outcomes among women with breast cancer.N Engl J Med. 329:326–331. 1993.
Solberg LI, Peterson KE, Ellis RW, et al. The Minnesota project: a focused approach to ambulatory quality assessment.Inquiry. 27:359–367. 1990.
Billings J, Zeitel L, Luknmnik J, et al.Analysis of Variation in Hospital Admission Rates Associated with Area Income in New York City. United Hospital Fund of New York: New York City. 1992.
Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland.JAMA. 268:2388–2394. 1992.
Wissow LS, Gittelsohn AM, Szklo M, et al. Poverty, race, and hospitalization for childhood asthma.Am J Public Health. 78:777–782. 1988.
Aday LA, Andersen RM. Equity of access to medical care: a conceptual and empirical overview.Med Care. 19 (Supplement):4–27. 1981.
U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 180.Money Income of Households, Families, and Persons in the U.S.: 1991, Washington, D.C.: U.S. Government Printing Office. 1992.
Galveston County Health District.4C's Clinics Need Assessment. Galveston, Texas. July, 1992.
Texas Department of Human Services.1989 Special Texas Census: Summary of Findings. Austin, Texas: Forecasting and Demographics Section. 1990.
Texas Department of Human Services.Physician Participation Report. Austin, Texas: Systems Suport Section. April, 1993.
Galveston County Health District. Presentation of the Director to Commissioner's Court on July 13, 1992 on Indigent Health Care. Galveston, Texas.
Duebner DC, et al. Logistic model estimation of death atributable to risk factors for cardiovascular disease in Evans County, Georgia.Am J Epidemiology. 112:135–143. 1980.
Collins R, Wallengerg CS. Pharmacological prevention and treatment of hypertensive disorders in pregnancy. In Chalmers, et al.,Effective Care in Pregnancy and Childbirth. New York: Oxford University Press. 1988.
Kass EH. Bacteriuria and pyelonephritis of pregnancy.Arch Internal Medicine. 105:194–198. 1960.
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This research was supported by the medical society and the four local hospitals serving Galveston County, Texas. We wish to thank John Deane, Stephen J. Spann, M.D., and William S. Riggins, M.D. for their assistance throughout the project.
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Begley, C.E., Slater, C.H., Engel, M.J. et al. Avoidable hospitalizations and socio-economic status in Galveston County, Texas. J Community Health 19, 377–387 (1994). https://doi.org/10.1007/BF02260406
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DOI: https://doi.org/10.1007/BF02260406