Dataset Information

Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care across Multiple States with Implications for Targeted Interventions.

ABSTRACT:

Objective

To quantify disparities in accessibility and availability of pediatric primary care by modeling interventions across multiple states that compare publicly insured versus privately insured children, and urban versus rural communities.

Data sources

Secondary data sources include 2013 National Plan and Provider Enumeration System, 2009 MAX Medicaid claims, 2012 American Community Survey.

Study design

The study models accessibility and availability of care for all children in seven states.

Methods

Optimization modeling with access constraints is used to estimate access. Statistical hypothesis testing is used to quantify systematic disparities.

Principal findings

California has the best accessibility for privately insured children and Minnesota for publicly insured children. Mississippi has the lowest availability for both populations. Overall, the disparities in availability for pediatric primary care are not as significant as in accessibility. Both rural and urban communities are in need of improvement in accessibility to primary care for publicly insured children, although at varying levels across states.

Conclusions

Disparities in availability are not as significant as disparities in accessibility. Opportunities to improve access to pediatric primary care vary by state. Generating specific recommendations for small areas is critical to enabling health policy decision makers to improvement access.

SUBMITTER: Gentili M

PROVIDER: S-EPMC5980146 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care across Multiple States with Implications for Targeted Interventions.

Gentili Monica M Harati Pravara P Serban Nicoleta N O'Connor Jean J Swann Julie J

Health services research 20170613 3

<h4>Objective</h4>To quantify disparities in accessibility and availability of pediatric primary care by modeling interventions across multiple states that compare publicly insured versus privately insured children, and urban versus rural communities.<h4>Data sources</h4>Secondary data sources include 2013 National Plan and Provider Enumeration System, 2009 MAX Medicaid claims, 2012 American Community Survey.<h4>Study design</h4>The study models accessibility and availability of care for all chi ...[more]

PMID: 28612354

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Project description:To assess spatial accessibility measures to on-premise alcohol outlets at census block, census tract, county, and state levels for the United States.Using network analysis in a geographic information system, we computed distance-based measures (Euclidean distance, driving distance, and driving time) to on-premise alcohol outlets for the entire U.S. at the census block level. We then calculated spatial access-based measures, specifically a population-weighted spatial accessibility index and population-weighted distances (Euclidean distance, driving distance, and driving time) to alcohol outlets at the census tract, county, and state levels. A multilevel model-based sensitivity analysis was conducted to evaluate the associations between different on-premise alcohol outlet accessibility measures and excessive drinking outcomes.The national average population-weighted driving time to the nearest 7 on-premise alcohol outlets was 5.89 min, and the average population-weighted driving distance was 2.63 miles. At the state level, population-weighted driving times ranged from 1.67 min (DC) to 15.29 min (Arizona). Population-weighted driving distances ranged from 0.67 miles (DC) to 7.91 miles (Arkansas). At the county level, population-weighted driving times and distances exhibited significant geographic variations, and averages for both measures increased by the degree of county rurality. The population-weighted spatial accessibility indexes were highly correlated to respective population-weighted distance measures. Sensitivity analysis demonstrated that population weighted accessibility measures were more sensitive to excessive drinking outcomes than were population weighted distance measures.These results can be used to assess the relationship between geographic access to on-premise alcohol outlets and health outcomes. This study demonstrates a flexible and robust method that can be applied or modified to quantify spatial accessibility to public resources such as healthy food stores, medical care providers, and parks and greenspaces, as well as, quantify spatial exposure to local adverse environments such as tobacco stores and fast food restaurants.

Dataset Information

Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care across Multiple States with Implications for Targeted Interventions.

Objective

Data sources

Study design

Methods

Principal findings

Conclusions

Publications

Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care across Multiple States with Implications for Targeted Interventions.

Similar Datasets

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