DataWatch Impact Of Socioeconomic Status On Hospital Use In New York City

This DataWatch examines the potential impact of socioeconomic differences on rates of hospitalization, based on patterns of hospital use in New York City in 1988. The research suggests that lack of timely and effective outpatient care may lead to higher hospitalization rates in low-income areas. For certain conditions identified as ambulatory care sensitive, hospitalization rates were higher in low-income areas than they were in higher-income areas where appropriate outpatient care was more readily available. Further study is needed to determine the relative impact of various economic, structural, and cultural factors that affect access to care. As the issues of universal coverage and health system reform become more focused in public policy discussions, it is critical that policymakers understand how medically indigent patients currently use the health care system and how barriers to care can affect health status and resource use. This study focuses on patterns of hospital use in New York City. Large variations in rates of hospitalization have been documented in studies comparing rates among nations, regions, states, communities, and neighborhoods. While a broad range of explanations has been offered, most research has centered on the impact of differences in physician decision making that result from the uncertainties inherent in medical practice and the lack of definitive scientific evidence for many clinical decisions. In our research we examine an area that has been less thoroughly explored: the potential impact of differences in socioeconomic status on hospitalization rates. Our goals were to improve our understanding of the causes of any variation in hospital use that is associated with income levels of area residents and to determine whether small-area analysis might become a useful tool for assessing barriers to outpatient care and for evaluating the effectiveness of programs designed to improve access to care. John Billings is principal investigator of the Ambulatory care Access Project, United Hospital Fund of New York. At the time of this study Lisa Zeitel was a senior analyst at the United Hospital Fund; she is now manager of the Managed Care Service Group, Met Life. Joanne Lukomnik is a senior health fellow in the Bureau of Health Care Delivery and Assistance, U.S. Public Health Service. Timothy Carey is chief of the Division of General Medicine, University of North Carolina at Chapel Hill. Arthur Blank is director of the Department of Research. Analysis, and Planning at the United Hospital Fund, and Laurie Newman is a research associate there. on S etem er 5, 2017 by H W T am H ealth A fairs by http://conealthaffairs.org/ D ow nladed fom