Determinants of Access to Care and Subsequent Emergency Department Use: The Experience of Latino Participants in Durham County's LATCH Program
Public Deposited- Last Modified
- January 26, 2020
- Creator
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Zimmerman, Kanecia Obie
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Introduction: The health care sector has become the focal point of health and is increasingly viewed as the necessary factor for decreased morbidity and mortality. As several studies have linked increases in health care costs to poor access to ambulatory care and subsequent utilization of the Emergency Department (ED), programs have been implemented to increase access to ambulatory care and reduce inappropriate utilization of the ED. Despite the existence of these programs, it is unclear from existing literature what factors determine access to ambulatory care and subsequent utilization of the ED, particularly for Latino persons with low levels of ambulatory care access and poorer health outcomes when compared to non-Latino whites. In this report, we evaluate factors associated with access to ambulatory care for Latino participants of Durham Count's LATCH program and determine whether access to care is associated with utilization of the ED. Methods: We collected connnunity-based data from 448 participants in the LATCH program. We evaluated the individual associations between patient characteristics (age, gender, duration lived in the U.S., birthplace, language concordance with a health care provider, satisfaction with health care, existence of a usual source of care, perceived racial discrimination, self-rated health status, insurance status, and care management status) and access to ambulatory health care. We then evaluated these patient characteristics in relation to utilization of the ED. Analyses were performed for a subgroup of participants with at least one ambulatory sensitive condition (asthma, diabetes, hypertension) and for participants without a condition. Results: For participants without an ambulatory sensitive condition, care management and language discordance with a health care provider were significantly associated with access to ambulatory care. For those with a condition, self-rated health status and insurance status were significantly associated with access to health care. For those without an ambulatory sensitive condition, self-rated health status was significantly associated with use of the ED. No factors were significantly associated with use of the ED among those with an ambulatory sensitive condition. Conclusions: In both persons with ambulatory sensitive conditions and those without, the factors that mediate access to ambulatory care do not appear to be similar to those that mediate visits to the emergency department. A larger study is needed to clarify these important questions.
- Date of publication
- May 2006
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Research or research design
- Track: HC&P
- Advisor
- Hoyo, Cathrine
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2006
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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This work has no parents.