Changes in Emergency Department Access Between 2001 and 2005 Among General and Vulnerable Populations
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Authors
Shen, Yu-Chu
Hsia, Renee Y.
Subjects
Advisors
Date of Issue
2010-08
Date
Publisher
Language
Abstract
Objectives. We analyzed how ease of geographic access to emergency
departments (EDs), defined as driving time to the closest ED, changed between
2001 and 2005, and whether access deterioration was more likely to occur in
vulnerable communities.
Methods. We classified communities on the basis of American Hospital
Association and Census data into 3 categories according to driving time to the
nearest ED: no increase, less than a 10-minute increase, and a 10-minute or more
increase. We estimated a multinomial logit model to examine the relative risk
ratio (RRR) of various community characteristics.
Results. More than 95% of communities experienced no ED access deterioration.
However, 11.4 million people experienced increased driving time to their
nearest ED. Low-income communities had a higher risk of facing deteriorating
access compared with high-income communities (urban: RRR=3.67; P<.01;
rural: RRR=1.75; P<.10), and communities with higher shares of Hispanics also
had higher risks of facing declines (urban: RRR=3.41; P<.10; rural: RRR=2.67;
P<.01).
Conclusions. Deteriorating access to EDs is more likely to occur in communities
with economic hardship and high shares of Hispanic populations. The
uneven access to critical services warrants increased attention from policymaking
bodies.
Type
Article
Description
The article of record as published may be found at http://dx.doi.org/10.2105/AJPH.
2009.175828
Series/Report No
Department
Business & Public Policy (GSBPP)
Organization
Naval Postgraduate School (U.S.)
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NPS Report Number
Sponsors
Funder
Robert Wood Johnson
Foundation’s Changes in Health Care Financing and Organization initiative (grant 63974)
Robert Wood Johnson Foundation’s Physician Faculty Scholars Program and the National Institutes of Health/National Center for Research Resources, University of California, San Francisco Clinical and Translational Science (KL2 RR024130)
Robert Wood Johnson Foundation’s Physician Faculty Scholars Program and the National Institutes of Health/National Center for Research Resources, University of California, San Francisco Clinical and Translational Science (KL2 RR024130)
Format
Citation
Shen, Yu-Chu, and Renee Y. Hsia. "Changes in emergency department access between 2001 and 2005 among general and vulnerable populations." American journal of public health 100.8 (2010): 1462-1469.
Distribution Statement
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This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.