The Impact of Spatial Accessibility of Healthcare on Elderly Potentially Preventable Emergency Department Visits in the Texas Coastal Bend Area

Authors: Yuxia Huang*, Texas A&M University - Corpus Christi, PAMELA MEYER2, Texas A&M University – Corpus Christi, Lei Jin, Texas A&M University – Corpus Christi
Topics: Geography and Urban Health
Keywords: Potentially preventable conditions, emergency department visits, elderly, spatial access to healthcare, neighborhood socioeconomic characteristics
Session Type: Paper
Day: 4/5/2019
Start / End Time: 5:00 PM / 6:40 PM
Room: Truman, Marriott, Mezzanine Level
Presentation File: No File Uploaded


The objective of this study is to explore the impact of spatial accessibility of healthcare on potentially preventable emergency department (ED) visits for adults aged 65 years and over in the Texas Coastal Bend area. With a total population of over 599,000 in 2010 with majority Hispanics (56%), this area has limited access to healthcare services, particularly for older adults, as well as a high hospitalization rate for potentially preventable conditions for older adults.
ED visit data were from 15 counties in the Texas Coastal Bend from September 1, 2009 and August 1, 2012. Potentially preventable ED visits for elderly were estimated based on Agency for Healthcare Research and Quality’s (AHRQ’s) ACSC and Prevention Quality Indicators. Spatial access to general practices and to hospitals, respectively at the zip code level were estimated using the enhanced two-step floating catchment area method. Using multivariable regression models, we estimated associations of elderly ACSC ED visits with neighborhood socioeconomic characteristics and spatial accessibility of healthcare.
The results show that spatial access to healthcare and neighborhood socioeconomic characteristics affect the rate of elderly ACSC ED visits. More specifically, spatial access to general practices and hospitals play inverse roles in the rate of elderly ACSC ED visits. Poorer access to general practices but easier access to hospitals contribute to the higher elderly ACSC ED rate at the zip code level. Higher rates of elderly ACSC ED visits are significantly associated with higher rates of elderly Hispanic and poverty at the zip code level.

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