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Keywords

Preventable hospitalizations; hotspots; GIS

Disciplines

Community Health and Preventive Medicine | Epidemiology | Public Health | Public Health Education and Promotion

Abstract

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH spatial clusters were observed among the total population with an average PH rate of 3,046.6 per 100,000 population. Among whites, the average PH rate was 3,339.9 per 100,000 in 11 PH spatial clusters. Only five PH spatial clusters were observed among African Americans with a higher average PH rate (3,710.8 per 100,000). The locations and other characteristics of PH spatial clusters differed by race. These results can be used to target resources to areas with high PH rates. Because PH spatial clusters are observed in differing locations for African Americans, approaches that include cultural tailoring may need to be specifically targeted.


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