Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data

Bradford E Jackson1, Sumihiro Suzuki1, David Coultas2, Fenghsiu Su1,3, Ravi Lingineni1, Karan P Singh1, Alfred Bartolucci4, Sejong Bae11Department of Biostatistics, University of North Texas Health Science Center School of Public Health, Fort Worth, TX, 2Department of Medicine, University of Texas H...

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Main Authors: Jackson BE, Suzuki S, Coultas D, Su F, Lingineni R, Singh KP, Bartolucci A, Bae S
Format: Article
Language:English
Published: Dove Medical Press 2011-11-01
Series:International Journal of COPD
Online Access:http://www.dovepress.com/safety-net-facilities-and-hospitalization-rates-of-chronic-obstructive-a8647
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spelling doaj-b9f3baaf7dde42b3951c8d533cb174e72020-11-25T01:36:41ZengDove Medical PressInternational Journal of COPD1176-91061178-20052011-11-012011default563571Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient dataJackson BESuzuki SCoultas DSu FLingineni RSingh KPBartolucci ABae SBradford E Jackson1, Sumihiro Suzuki1, David Coultas2, Fenghsiu Su1,3, Ravi Lingineni1, Karan P Singh1, Alfred Bartolucci4, Sejong Bae11Department of Biostatistics, University of North Texas Health Science Center School of Public Health, Fort Worth, TX, 2Department of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX, 3Center for Learning and Development, University of North Texas Health Science Center, Fort Worth, TX, 4Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USAPurpose: Geographic disparities in hospitalization rates for chronic obstructive pulmonary disease (COPD) have been observed in Texas. However, little is known about the sources of these variations. The purpose of this manuscript is to further explore the geographic disparity of COPD hospitalization rates in Texas by examining county-level factors affecting access to care.Patients and methods: The study is a cross-sectional analysis of the 2007 Texas Health Care Information Council, Texas, demographer population projections and the 2009 Area Resource File (ARF). The unit of analysis was county-specific hospitalization rate, calculated as the number of discharges of county residents divided by county-level population estimates. Indicators of access to care included: type of safety-net facility and number of pulmonary specialists in a county. Safety-net facilities of interest were federally qualified health centers (FQHCs) and rural health clinics (RHCs).Results: There was a significant difference (P < 0.05) in hospitalization rates according to health center presence. Counties with only FQHCs had the lowest COPD hospitalization rate (132 per 100,000 observations), and counties with only RHCs had the highest hospitalization rate (229 per 100,000 observations). The presence of a pulmonary specialist was associated with a significant decrease (25%) in hospitalization rates among counties with only FQHCs.Conclusion: In Texas, counties with only FQHCs were associated with lower COPD hospitalization rates. The presence of a RHC alone may be insufficient to decrease hospitalizations from COPD. There are a number of factors that may contribute to these variations in hospitalization rates, such as racial/ethnic distribution, types and quality of services provided, and the level of rurality, which creates greater distances to care and lower concentration of hospitals and pulmonary specialists.Keywords: health centers, COPD, health disparitieshttp://www.dovepress.com/safety-net-facilities-and-hospitalization-rates-of-chronic-obstructive-a8647
collection DOAJ
language English
format Article
sources DOAJ
author Jackson BE
Suzuki S
Coultas D
Su F
Lingineni R
Singh KP
Bartolucci A
Bae S
spellingShingle Jackson BE
Suzuki S
Coultas D
Su F
Lingineni R
Singh KP
Bartolucci A
Bae S
Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
International Journal of COPD
author_facet Jackson BE
Suzuki S
Coultas D
Su F
Lingineni R
Singh KP
Bartolucci A
Bae S
author_sort Jackson BE
title Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
title_short Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
title_full Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
title_fullStr Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
title_full_unstemmed Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data
title_sort safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 texas health care information council inpatient data
publisher Dove Medical Press
series International Journal of COPD
issn 1176-9106
1178-2005
publishDate 2011-11-01
description Bradford E Jackson1, Sumihiro Suzuki1, David Coultas2, Fenghsiu Su1,3, Ravi Lingineni1, Karan P Singh1, Alfred Bartolucci4, Sejong Bae11Department of Biostatistics, University of North Texas Health Science Center School of Public Health, Fort Worth, TX, 2Department of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX, 3Center for Learning and Development, University of North Texas Health Science Center, Fort Worth, TX, 4Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USAPurpose: Geographic disparities in hospitalization rates for chronic obstructive pulmonary disease (COPD) have been observed in Texas. However, little is known about the sources of these variations. The purpose of this manuscript is to further explore the geographic disparity of COPD hospitalization rates in Texas by examining county-level factors affecting access to care.Patients and methods: The study is a cross-sectional analysis of the 2007 Texas Health Care Information Council, Texas, demographer population projections and the 2009 Area Resource File (ARF). The unit of analysis was county-specific hospitalization rate, calculated as the number of discharges of county residents divided by county-level population estimates. Indicators of access to care included: type of safety-net facility and number of pulmonary specialists in a county. Safety-net facilities of interest were federally qualified health centers (FQHCs) and rural health clinics (RHCs).Results: There was a significant difference (P < 0.05) in hospitalization rates according to health center presence. Counties with only FQHCs had the lowest COPD hospitalization rate (132 per 100,000 observations), and counties with only RHCs had the highest hospitalization rate (229 per 100,000 observations). The presence of a pulmonary specialist was associated with a significant decrease (25%) in hospitalization rates among counties with only FQHCs.Conclusion: In Texas, counties with only FQHCs were associated with lower COPD hospitalization rates. The presence of a RHC alone may be insufficient to decrease hospitalizations from COPD. There are a number of factors that may contribute to these variations in hospitalization rates, such as racial/ethnic distribution, types and quality of services provided, and the level of rurality, which creates greater distances to care and lower concentration of hospitals and pulmonary specialists.Keywords: health centers, COPD, health disparities
url http://www.dovepress.com/safety-net-facilities-and-hospitalization-rates-of-chronic-obstructive-a8647
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