Jamie Fishman M.S., Sara McLafferty Ph.D., William Galanter M.S., M.D., Ph.D.
To examine the contributions of individual‐ and neighborhood‐level spatial access to care to the utilization of emergency departments (s) for preventable conditions through implementation of novel local spatial access measures.
Emergency department admissions data are from four Health member hospitals in Chicago from 2007 to 2011. Primary care physician office and clinic locations were obtained from the American Medical Association and the City of Chicago.
Multilevel logit regression was used to model the relationship between individual‐ and neighborhood‐level attributes and preventable use.
Data Sources/Study Setting
Emergency department admissions data were classified based on the primary diagnosis for each encounter. Spatial access to care indices were generated in Arc, and values were extracted at each code centroid to match patients' codes.
Beyond sociodemographic factors such as gender and race, patients living in medically underserved areas (MUAs) and areas with lower spatial access to primary care clinics had higher odds of preventable use.
Preventable use can be associated with sociodemographic characteristics, as well as spatial access to primary care services. This study reveals potential for using local measures of spatial accessibility for preventable analyses.
Data Collection/Extraction Methods