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Show Hospital Admission and Poverty Status: A New York University Analysis A Report by Nichole Adams, B.S., Utah's Health: An Annual Review Editorial Board Staff In March of 1998, the Governor Scott M. Matheson Center for Health Care Studies held a policy forum to announce the Center's name change from the FHPF Center. As a special guest, John Billings (Associate Professor at New York University) presented his latest analysis of original research identifying the relationship between hospital admission rates and income levels within metropolitan areas. The following is a brief report of the hospital admissions data he presented. The methodology used for the analysis included five parts: (1) defining geographic areas; (2) tracking hospital admissions of area residents wherever they occur; (3) calculating admission rates for each area (per/1,000 residents); (4) adjusting data by age and sex; and (5) analyzing patterns of utilization rates. Ambulatory Care Sensitive (ACS) conditions were analyzed in the study because hospitalization for these conditions is a sign of limited or inadequate primary care. Figure 1 New York City Appendectomy Admissions Ages 0-64 - 1996 lowlnc/Hlghluc * 1.08 Cool Vai ¦ .331 Moan Rnl« - 0.80 Each '¦' ropresuntb a zip code area 0% 10% 20% 30% 40% 50"* % Households Income < $15,000 SPABCS. UHF. NYU HMWl Hsso.lch Pragiain Professor Billings presented Figure 1 as a base case. Appendectomies are not an Ambulatory Care Sensitive (ACS) condition and cannot be prevented by routine preventive care. Most all individuals that develop appendicitis are admitted to a hospital. This figure shows that in 1996 essentially no relationship can be asserted between appendectomy admissions and income level for New York City residents ages 0-64. Figure 2 New York City Ambulatory Care Sensitive (ACS) Admissions Ages 0-64 - 1996 60- Adms/1.000 50- H*.JM Lowlnc/Highlnc ¦ 3 52 Coal Vw • 5IS • 40- 30- 20- 10- * 0- Each '¦' represents a zip code area 0% 10% 20% 30% 40% 50% % Households Income < $15,000 Source Sf ARCS, UHF. NYU Health Rauaren PioQiam Figure 2 shows a relationship between Ambulatory Care Sensitive (ACS) admissions and income level. In geographic areas where ten percent or less of household income is less than $15,000, there are less than ten ACS admissions per 1,000 residents. But in geographic areas where 60 percent of the household incomes are less than $15,000, there are approximately 40 ACS admissions per 1,000 residents. Figure 3 New York City Ambulatory Care Sensitive (ACS) Admissions Ages 65+ • 1996 AUms/1,000 H2. .308 lowtocMkjnlnc-2.1? V.k" •" ¦ " Each '¦' represents a zip code arou 20% 30% 40% 50% % Households Income < $15,000 Suite* iil'AKCS. Ulll. NYu m»lu> ivs Figure 3 shows that although ACS admissions for New York City residents over 65 are related to income levels, the degree of relation is much less than that for those under 65 years of age. This may be related to the fact that this population is provided health coverage through Medicare. 145 |
