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Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Journal of Urban Health volume 93, pages 974–983 (2016)Cite this article

Abstract

Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators (PQIs) developed by the Agency for Healthcare Research and Quality were applied to inpatient hospitalization data from the New York State Department of Health’s Statewide Planning and Research Cooperative System. PQIs were classified into composites. From 2008 to 2013, preventable hospitalization rates per 100,000 adults across each poverty group decreased. For very high poverty neighborhoods (ZIP codes with ≥30 % of persons living below the federal poverty level (FPL)), there were significant decreases overall (3430.56 to 2543.10, annual percent change [APC] = −5.91 %), for diabetes (676.15 to 500.83, APC = −5.75 %), respiratory (830.78 to 660.29, APC = −4.85 %), circulatory (995.69 to 701.81, APC = −7.24 %), and acute composites (928.18 to 680.17, APC = −5.62 %). The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with <10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

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Acknowledgments

We thank Shadi Chamany for her review and constructive comments on the preparation of this manuscript.

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Affiliations

  1. New York City Department of Health and Mental Hygiene, New York, NY, USA

    Angelica Bocour & Maryellen Tria

Authors
  1. Angelica Bocour
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  2. Maryellen Tria
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Correspondence to Angelica Bocour.

Appendix

Appendix

TABLE 1 Rate ratios by Prevention Quality Indicator (PQI) for New York City residents living in very high poverty neighborhoods versus low poverty neighborhoods, 2008–2013
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Bocour, A., Tria, M. Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013. J Urban Health 93, 974–983 (2016). https://doi.org/10.1007/s11524-016-0090-5

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  • DOI: https://doi.org/10.1007/s11524-016-0090-5

Keywords

  • Preventable hospitalizations
  • Ambulatory care sensitive hospitalizations
  • Neighborhood poverty