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Primary Care Availability, Safety Net Clinics, and Health Insurance Coverage

The Association of These Access Factors With Preventable Hospitalizations

Murty, Sharanya MS, PhD; Begley, Charles E. PhD; Franzini, Luisa PhD; Swint, J. Michael PhD

The Journal of Ambulatory Care Management: July/September 2016 - Volume 39 - Issue 3 - p 253–263
doi: 10.1097/JAC.0000000000000115
Original Articles
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The objective of the study was to examine the relationship between physician/safety net availability and health insurance coverage and preventable hospitalizations (PHs) in nonelderly adults in an urban area. Preventable conditions (PHs) were identified for nonelderly adults in Harris County using the Texas Health Care Information Collection hospital database. Multivariable logistic regression models examined the association of health insurance and patient proximity to physicians and safety net clinics with the risk of a PH. Safety net availability reduced PH risk by 23% (P < .05) but only among the uninsured. Lack of health insurance increased PH risk by 30% (P < .05).

Comprehensive Health Insights, Louisville, Kentucky (Dr Murty); and Management and Policy Sciences (Dr Begley), Division of Management, Policy and Community Health (Dr Franzini), and George McMillan Fleming Professor (Dr Swint), School of Public Health, The University of Texas Health Science Center at Houston, Houston.

Correspondence: J. Michael Swint, PhD, George McMillan Fleming Professor, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030 (John.M.Swint@uth.tmc.edu).

This research was conducted while Sharanya Murty was a graduate student at the School of Public Health, The University of Texas Health Science Center at Houston, Houston.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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