Geospatial cluster analyses of pneumonia-associated hospitalisations among adults in New York City, 2010–2014

Abstract

Pneumonia is a leading cause of death in New York City (NYC). We identified spatial clusters of pneumonia-associated hospitalisation for persons residing in NYC, aged ⩾18 years during 2010–2014. We detected pneumonia-associated hospitalisations using an all-payer inpatient dataset. Using geostatistical semivariogram modelling, local Moran'sIcluster analyses andχ2tests, we characterised differences between ‘hot spots’ and ‘cold spots’ for pneumonia-associated hospitalisations. During 2010–2014, there were 141 730 pneumonia-associated hospitalisations across 188 NYC neighbourhoods, of which 43.5% (N= 61 712) were sub-classified as severe. Hot spots of pneumonia-associated hospitalisation spanned 26 neighbourhoods in the Bronx, Manhattan and Staten Island, whereas cold spots were found in lower Manhattan and northeastern Queens. We identified hot spots of severe pneumonia-associated hospitalisation in the northern Bronx and the northern tip of Staten Island. For severe pneumonia-associated hospitalisations, hot-spot patients were of lower mean age and a greater proportion identified as non-Hispanic Black compared with cold spot patients; additionally, hot-spot patients had a longer hospital stay and a greater proportion experienced in-hospital death compared with cold-spot patients. Pneumonia prevention efforts within NYC should consider examining the reasons for higher rates in hot-spot neighbourhoods, and focus interventions towards the Bronx, northern Manhattan and Staten Island.

Geographic Heterogeneity in Influenza and Pneumonia Mortality in Hispanic Americans

“…Despite being served more often in lower-performing hospitals, HW still had lower AAMR. Central metropolitan residence and insurance status (e.g., Medicaid, self-pay) often determine usage of such facilities by HW [ 11 , 12 ].…”

“…Some insight into this deviation may be derived from a closer look at New York City (NYC), the largest metropolitan area in Region 2 with a Hispanic population of approximately 2.5 million individuals (29% of the population) [ 13 ]. In contrast to the US, IP is the third leading cause of death in NYC [ 12 ]. A geospatial analysis of pneumonia hospitalization was done in 188 neighborhood tabulation areas (NTA) in 2004–2006 [ 12 ].…”

“…In contrast to the US, IP is the third leading cause of death in NYC [ 12 ]. A geospatial analysis of pneumonia hospitalization was done in 188 neighborhood tabulation areas (NTA) in 2004–2006 [ 12 ]. In clusters of NTA with high IP age-adjusted hospitalization rates, 29.4% of patients were Hispanic [ 12 ].…”

“…In clusters of NTA with high IP age-adjusted hospitalization rates, 29.4% of patients were Hispanic [12]. In clusters of NTA with low IP rates, only 5.0% of patients were Hispanic [12].…”

“…In contrast to the US, IP is the third leading cause of death in NYC [12]. A geospatial analysis of pneumonia hospitalization was done in 188 neighborhood tabulation areas (NTA) in 2004-2006 [12].…”