Decomposing Urban and Rural Disparities of Preventable ED Visits Among Patients With Alzheimer's Disease and Related Dementias
Evidence of the Availability of Health Care Resources
Bibliographic Data
| ID | 22933023 |
|---|---|
| Authors | Nianyang Wang (0000-0001-6798-3492, Department of Health Policy and Management School of Public Health University of Maryland College Park Maryland, corresponding author), Asmaa Albaroudi (Department of Health Policy and Management School of Public Health University of Maryland College Park Maryland), Jie Chen (0000-0002-9254-4413, Department of Health Policy and Management School of Public Health University of Maryland College Park Maryland) |
| Year | 2021 |
| Volume | 37 |
| Issue | 3 |
| Pages | 624-635 |
| Publication date | 2021-06-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | The Journal of Rural Health (JOURNAL) |
| Journal identifiers | ISSN: 0890-765X • E-ISSN: 1748-0361 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/jrh.12465 |
| PMID | 32613666 |
| OpenAlex | W3039202479 |
| Language | EN |
| Citations received | 4 |
| References cited | 33 |
PURPOSE: The purpose of this study was to examine the urban and rural differences in the frequency of preventable Emergency Department (ED) visits among Alzheimer's Disease and Related Dementias (ADRD) patients, with a focus on the availability of health care resources in urban and rural areas. METHODS: Linked datasets of 2015 State Emergency Department Databases from the Healthcare Cost and Utilization Project and the Area Health Resource File were used. ED discharges of 7 states were included in our analysis. We performed a state fixed-effect multivariable logistic regression to estimate the variation of preventable EDs by urban and rural areas. Individual characteristics and county-level health care resources were included in the estimation. The Oaxaca decomposition was used to quantify the association of county-level health care resources and urban/rural disparities. FINDINGS: Rural patients with ADRD had 1.23 higher adjusted odds (P < .001) of going to the ED for a preventable visit compared to urban counterparts. The decomposition results showed that the model specification explained 49.2% of the differences between urban and rural patients. Patient residence in a mental health professional shortage area is one of the driving factors (contributing to 27%-48%) that explained the urban and rural disparities. CONCLUSIONS: Our study demonstrates the importance of improving health care resources in rural areas to improve health care quality and outcomes among ADRD patients who reside in rural areas. Future research and data collection on unobserved factors, such as health care quality, will be helpful in explaining the geographic differences.
Economic growth · Emergency department · Environmental health · Health care · Health equity · Logistic regression · Public health · Residence · Rural area · Rural health · Chronic Disease Management Strategies · Dementia and Cognitive Impairment Research · Demography · Emergency and Acute Care Studies · Medicine · Nursing · Gerontology
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| Citations per year | 0.67 |
|---|---|
| Citation span | 2020 - 2026 (7) |
| Highly cited | No |