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Hospital utilization for ambulatory care sensitive conditions: health outcome disparities associated with race and ethnicity

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  • Laditka, James N.
  • Laditka, Sarah B.
  • Mastanduno, Melanie P.

Abstract

Our study examines associations between race and ethnicity and hospitalization for ambulatory care sensitive (ACS) conditions for working age adults, and for individuals age 65 or older. We use ACS hospitalization as an outcome indicator to evaluate access to primary care. The prevalence of ACS conditions in the population, including those not hospitalized, and the occurrence of ACS and non-ACS hospitalization, are estimated using nationally representative data from the 1997 US Medical Expenditure Panel Survey. We calculate population-based relative rates of ACS hospitalization using the 1997 Nationwide Inpatient Sample, a large sample of United States' community hospitals, and the US Census. We investigate the sensitivity of these relative rates to the inclusion of conditions for which hospitalization varies notably across areas, and adjust the rates for both underlying hospitalization patterns for non-ACS conditions, and for disease prevalence in the population groups studied. The analyses consistently show that African Americans and Hispanics have significantly higher rates of ACS hospitalization than non-Hispanic whites. This result applies to women and men, and both age groups studied. These higher rates persist after adjusting for disease prevalence and non-ACS admission rates, and for the inclusion of high variation conditions.

Suggested Citation

  • Laditka, James N. & Laditka, Sarah B. & Mastanduno, Melanie P., 2003. "Hospital utilization for ambulatory care sensitive conditions: health outcome disparities associated with race and ethnicity," Social Science & Medicine, Elsevier, vol. 57(8), pages 1429-1441, October.
    • Handle: RePEc:eee:socmed:v:57:y:2003:i:8:p:1429-1441
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    Citations

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    Cited by:

    1. Cyril Chang & Jennifer Troyer, 2009. "The impact of TennCare on hospital efficiency," Health Care Management Science, Springer, vol. 12(3), pages 201-216, September.
    2. Islam, M. Kamrul & Kjerstad, Egil, 2017. "Is incentivizing by subsidizing a better way of managing chronic health conditions?," Working Papers in Economics 12/17, University of Bergen, Department of Economics.
    3. repec:idb:brikps:72698 is not listed on IDEAS
    4. Butler, Danielle C. & Thurecht, Linc & Brown, Laurie & Konings, Paul, 2013. "Social exclusion, deprivation and child health: a spatial analysis of ambulatory care sensitive conditions in children aged 0–4 years in Victoria, Australia," Social Science & Medicine, Elsevier, vol. 94(C), pages 9-16.
    5. M. Kamrul Islam & Egil Kjerstad, 2019. "Co-ordination of health care: the case of hospital emergency admissions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 525-541, June.
    6. Anna-Theresa Renner, 2020. "Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 85-104, February.
    7. Schut, Rebecca A., 2021. "Racial disparities in provider-patient communication of incidental medical findings," Social Science & Medicine, Elsevier, vol. 277(C).

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