Residential Segregation, Neighborhood Health Care Organizations, and Children's Health Care Utilization in the Phoenix Urbanized Area

2020 ◽  
Vol 19 (3) ◽  
pp. 771-801
Author(s):  
Kathryn Freeman Anderson

Research has demonstrated health care consequences of racial/ethnic residential segregation. Here, I test one possible mechanism—the distribution of community health care organizations and service providers across urban communities. Using data from a 2013 survey on children's health care utilization in the Phoenix urbanized area combined with data on a 2013 census of health care organizations, I estimate a series of statistical models in order to test this relationship. I find that Latino and Native American segregation is related to a lower density of health care organizations. Furthermore, the lack of these resources increases the odds of a family using a clinic, versus a physician's office, which is a more ideal source of care. Finally, a higher rate of racial/ethnic clustering is also related to greater utilization of a clinic, as opposed to a physician's office, and this association is partially mitigated by distribution of health care organizations.

2021 ◽  
pp. 108482232110013
Author(s):  
Tami M. Videon ◽  
Robert J. Rosati ◽  
Steven H. Landers

COVID-19 patients represent a new and distinct population in home health care. Little is known about health care utilization and incremental improvements in health for recovering COVID-19 patients after admission to home health care. Using a retrospective observational cohort study of 5452 episodes of home health care admitted to a New Jersey Home Health Agency between March 15 and May 31, 2020, this study describes COVID-19 Home Health Care (HHC) patients ( n = 842) and compare them to the general HHC population ( n = 4610). COVID HHC patients differ in significant ways from the typical HHC population. COVID patients were more likely to be 65 years of age and younger (41% vs 26%), be from a racial/ethnic minority (60% vs 31%), live with another person (85% vs 76%), have private insurance (28% vs 16%), and began HHC with greater independence in activities-of-daily-living (ADL/IADLs). COVID patients received fewer overall visits than their non-COVID counterparts (11.7 vs 16.3), although they had significantly more remote visits (1.7 vs 0.3). Multivariate analyses show that COVID patients early in the pandemic were 34% (CI, 28%-40%) less likely to be hospitalized and demonstrated significantly greater improvement in all the outcome measures examined compared to the general home health population.


2018 ◽  
Vol 39 (2) ◽  
pp. 201-213 ◽  
Author(s):  
Jo-Ana D. Chase ◽  
David Russell ◽  
Liming Huang ◽  
Alexandra Hanlon ◽  
Melissa O’Connor ◽  
...  

Few studies have explored racial/ethnic differences in health care outcomes among patients receiving home health care (HHC), despite known differences in other care settings. We conducted a retrospective cohort study examining racial/ethnic disparities in rehospitalization and emergency room (ER) use among post-acute patients served by a large northeastern HHC agency between 2013 and 2014 ( N = 22,722). We used multivariable binomial logistic regression to describe the relationship between race/ethnicity and health care utilization outcomes, adjusting for individual-level factors that are conceptually related to health service use. Overall rates of rehospitalization and ER visits were 10% and 13%, respectively. African American and Hispanic patients experienced higher odds of ER visits or rehospitalization during their HHC episode. Racial/ethnic differences in utilization were mediated by enabling factors, such as caregiver availability, and illness-level factors, such as illness severity, functional status, and symptoms. Intervention targets may include early risk assessment, proactive management of clinical conditions, rehabilitative therapy, and caregiver training.


2013 ◽  
Author(s):  
Cory R. Bolkan ◽  
Teri Davis ◽  
Laura Bonner ◽  
Kara Zivin ◽  
Duncan Campbell ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document