Do California counties with lower socioeconomic levels have less access to emergency department care?

Deepa Ravikumar, Renee Hsia

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: The study objective was to examine the relationship between number of emergency departments (EDs) per capita in California counties and measures of socioeconomic status, to determine whether individuals living in areas with lower socioeconomic levels have decreased access to emergency care. Methods: The authors linked 2005 data from the American Hospital Association (AHA) Annual Survey of Hospitals with the Area Resource Files from the United States Department of Health and Human Services and performed Poisson regression analyses of the association between EDs per capita in individual California counties using the Federal Information Processing Standard (FIPS) county codes and three measures of socioeconomic status: median household income, percentage uninsured, and years of education for individuals over 25 years of age. Multivariate analyses using Poisson regression were also performed to determine if any of these measures of socioeconomic status were independently associated with access to EDs. Results: Median household income is inversely related to the number of EDs per capita (rate ratio = 0.83; 95% confidence interval [CI] = 0.71 to 0.96). Controlling for income in the multivariate analysis demonstrates that there are more EDs per 100,000 population in FIPS codes with more insured residents when compared with areas having less insured residents with the same levels of household income. Similarly, FIPS codes whose residents have more education have more EDs per 100,000 compared with areas with the same income level whose residents have less education. Conclusions: Counties whose residents are poorer have more EDs per 100,000 residents than those with higher median household incomes. However, for the same income level, counties with more insured and more highly educated residents have a greater number of EDs per capita than those with less insured and less educated residents. These findings warrant in-depth studies on disparities in access to care as they relate to socioeconomic status.

Original languageEnglish (US)
Pages (from-to)508-513
Number of pages6
JournalAcademic Emergency Medicine
Volume17
Issue number5
DOIs
StatePublished - 2010
Externally publishedYes

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Emergency Medical Services
Hospital Emergency Service
Social Class
Automatic Data Processing
Education
Multivariate Analysis
American Hospital Association
United States Dept. of Health and Human Services
Regression Analysis
Confidence Intervals
Population

Keywords

  • Access to care
  • Access to emergency services
  • Emergency departments per capita
  • Health policy

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)

Cite this

Do California counties with lower socioeconomic levels have less access to emergency department care? / Ravikumar, Deepa; Hsia, Renee.

In: Academic Emergency Medicine, Vol. 17, No. 5, 2010, p. 508-513.

Research output: Contribution to journalArticle

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