DISPARITIES IN THE RATES OF ADMISSION FOR AMBULATORY CARE SENSITIVE CONDITIONS AMONG CHILDREN LIVING IN PENNSYLVANIA

Open Access
- Author:
- Hazzan, Afeez Abiola
- Graduate Program:
- Health Policy and Administration
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- None
- Committee Members:
- Marianne Messersmith Hillemeier, Thesis Advisor/Co-Advisor
- Keywords:
- Population Health
Ambulatory Care Sensitive Conditions
Health Disparities
Child Health - Abstract:
- Purpose: The purpose of this study is to investigate race/ethnic and age group disparities in the rates of admission for ambulatory care sensitive conditions (ACSC) among children living in Pennsylvania. Ambulatory care-sensitive conditions (ACSC) are illnesses such as asthma, dehydration, and bacterial pneumonia for which appropriate preventative and primary ambulatory care can greatly reduce the need for hospitalization. Rates of admission for these conditions are often viewed as indicators of the quality of primary care. Race/ethnic and age group differentials in the rates of admission for ACSC among children living in Pennsylvania during 2001 and 2005 are compared. Study Design: Rates of admission for the 10 most common ACS conditions are examined for African American, Hispanic, and white children aged 0-4, 5-9, 10-14, and 15-19 years, using 2001 and 2005 data from the Pennsylvania Health Care Cost Containment Council’s (PHC4) hospital discharge database and population information from the US Census Bureau. Logistic regression models are estimated to determine statistically significant differences in ACSC admission rates by race/ethnicity and age, and significant changes in these rate differences over time. Population Studied: African-American, Hispanic and white children aged 0 to 19 years living in Pennsylvania during 2001 and 2005. Principal Findings: African American children had higher rates of admission for most ACSC compared to Hispanics and whites in both 2001 and 2005. Hispanic children also had higher rates of admission for most ACSC compared to whites in both years, but the Hispanic-white disparities were not as pronounced as the African American-white disparities. Further, children who were younger tend to have higher rates of admission compared to older children. Comparisons of trends from 2001 to 2005 in ACSC hospitalization rate disparities are mixed, with disparities for some ACSC conditions increasing and some decreasing in each childhood age group. Many disparities in 2005, however, were not significantly changed from those observed in 2001. Conclusions: There are race/ethnic disparities in the rates of admission for ACSC among children living in Pennsylvania, and these disparities are most pronounced between African Americans and whites. Age group disparities also exist, with younger children being more likely to be admitted for ACSC compared to older children. Overall, the race/ethnic disparities have not changed significantly in 2005 compared to 2001. Policy Implications: Mechanisms underlying disparities in the rates of admission for ACSC among Pennsylvania children need to be investigated. Also, the fact that the disparities observed in 2001 were largely unchanged in 2005 implies that little progress was made between those years. Policy interventions that promote equitable, timely, and affordable access to quality care for all Pennsylvania children are needed.