The effect of geographic access on severe health outcomes for pediatric asthma
Abstract
Access to medical care and severe pediatric asthma outcomes vary with geography, but the relationship between them has not been studied. We sought to evaluate the relationship between geographic access and health outcomes for pediatric asthma. The severe outcome measures include emergency department (ED) visits and hospitalizations for children with an asthma diagnosis in Georgia and North Carolina. We quantify asthma prevalence, outcome measures, and factors included in the statistical model using multiple data sources. We calculate geographic access to primary and asthma specialist care using optimization models. We estimate the association between outcomes and geographic access in the presence of other factors using logistic regression. The model is used to project the reduction in severe outcomes with improvement in access. The association between access and outcomes for pediatric asthma depends on the type of outcome measure, type of care, and variations in other factors. The expression of this association is also different for the 2 states. Access to primary care plays a larger role than access to specialist care in explaining Georgia ED visits, whereas the reverse applies for hospitalizations. In North Carolina access to...Continue Reading
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Influence of Geographic Access on Surgical Center Readmissions After Index Congenital Heart Surgery.
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