The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China

Chen, Ting; Pan, Jay

doi:10.1007/s11205-020-02413-9

Cited by 23 publications

(28 citation statements)

References 52 publications

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“…The occurrence of PPH among high-cost patients was sizable (21.65%), indicating that 22 PPHs occurred per 100 high-cost persons. The occurrence of PPHs among high-cost patients was higher than that among non-high-cost patients (1.83%) and even higher than among patients older than 60 years (17.9%) as reported by Chen and Pan (23). However, the proportion of PPHs in total admissions among high-cost group (11.03%) was slightly lower than that among non-high-cost group (13.44%).…”

Section: Discussionmentioning

confidence: 54%

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Shunhua

Zhang

Liang

et al. 2022

Front. Public Health

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IntroductionHigh-cost patients are characterized by repeated hospitalizations, and inpatient cost accounts for a large proportion of their total health care spending. This study aimed to assess the occurrence and costs of potentially preventable hospitalizations and explore contributing factors among high-cost patients in rural China.MethodsWe examined a population-based sample of patients using the 2016 New Rural Cooperative Medical Scheme in Dangyang city, China. Eighteen thousand forty-three high-cost patients were identified. A validated tool and logistic regression analysis were used to determine preventable hospitalizations and their patient-level and supply-side factors.ResultsHigh-cost patients were older (average age of 54 years) than non-high-cost patients (50 years) and more likely to come from poverty-stricken families. The occurrence of preventable hospitalization was 21.65% among high-cost patients. The proportion of preventable inpatient cost in total inpatient and outpatient expenditure among high-cost patients (5.81%) was lower than that of non-high-cost patients (7.88%) but accounted for 75.87% of the overall preventable inpatient cost. High-cost patients with more hospitalizations were more likely to experience preventable hospitalization, and those with heart failure, COPD, diabetes and mixed conditions were at a higher risk of preventable hospitalization, while those with more outpatient visits were less likely to show preventable hospitalization.ConclusionsThe occurrence of preventable hospitalization among high-cost patients in rural China was sizeable. The preventable inpatient cost of the overall population was concentrated among high-cost patients. Interventions such as improving preventive care and disease management targeting high-cost patients within counties may improve patients' health outcomes and quality of life and reduce overall preventable inpatient cost.

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Section: Discussionmentioning

confidence: 54%

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Shunhua

Zhang

Liang

et al. 2022

Front. Public Health

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“…The shortage of doctors is particularly evident in rural areas [13]. This problem is very important due to the fact that good spatial accessibility to basic healthcare facilities significantly reduces the development of disease on a larger scale [6] and thus decreases the number of hospitalised patients among the elderly [7,8]. Access to healthcare is also a particularly important topic during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…The problem of access to healthcare facilities has a long history in geographical research, in which many additional concepts of accessibility can be found, including potential accessibility, revealed accessibility, and temporal and spatial measures of accessibility [3,[6][7][8]. Accessibility refers to the relative ease with which one can reach different places such as workplaces, shopping centres, or a healthcare facility.…”

Section: Methodsmentioning

confidence: 99%

“…In turn, the PHCs themselves can be the site of vaccine distribution at the local level. Good access to such services also significantly reduces the development of diseases on a larger scale [6], and thus decreases the number of hospitalised patients among the elderly [7,8]. This is particularly vital in Poland, which is expected to have the worst old-age dependency ratio among the EU countries by 2100 [9].…”

Section: Introductionmentioning

confidence: 99%

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Spatial Accessibility of Primary Health Care in Rural Areas in Poland

Lechowski

Jasion

2021

IJERPH

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The aim of the study was to assess the spatial accessibility of basic and universal healthcare (understood as primary healthcare (PHC) facilities) in rural statistical localities in Poland. Data from the National Health Fund, Central Statistical Office, National Register of Geographic Names and OpenStreetMap were used in the research. The research was carried out on the basis of modelled distance from the rural statistical localities to the nearest PHC facility. The methods used included network analysis, characteristics of normal point distribution, Theil index, and spatial autocorrelation. Areas where the greatest shortages of access to PHC facilities occurred were indicated on the basis of the analysis of their clustering density. The average distance from rural statistical localities in Poland to PHC facilities is about 5 km. Slightly more than 70% of the distance values are within one standard deviation of the mean. Better access to the examined healthcare facilities is available in the southern and central parts of Poland, while northern and eastern Poland, as well as the border areas, suffer from lower accessibility. Poor access to PHC occurs first of all at the border of Greater Poland Voivodeship with the Kuyavian–Pomeranian Voivodeship, on the border of the Lodz Voivodeship, in Masovian and Swietokrzyskie Voivodeship, and in the ring surrounding Warsaw, as well as in the Pomeranian Voivodeship. The research findings can be used to develop strategies to improve the accessibility of primary care facilities in rural areas.

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“…With the improvement of healthcare insurance systems, spatial access to healthcare resources is attracting increasing attention [11,12]. According to a survey conducted by China's National Bureau of Statistics, during the past two decades, people's financial access to healthcare has substantially improved, while spatial access to healthcare has become the primary reason why timely utilization of healthcare does not occur [13,14]. Generally, three factors are critical when measuring spatial access to healthcare resources: 1) the service capacity of healthcare institutions, 2) population demand, and 3) geographic impedance [15].…”

Section: Introductionmentioning

confidence: 99%

An integrated analysis of spatial access to the three-tier healthcare delivery system in China: A case study of Hainan Island

Wang

Seyler

Wang³

et al. 2021

Preprint

Self Cite

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Background: Access to healthcare is critical for the implementation of Universal Health Coverage. With the development of healthcare insurance systems around the world, spatial impedance to healthcare institutions has attracted increasing attention. However, most spatial access methodologies have been developed in Western countries, whose healthcare systems are different from those in Low- and Middle-Income Countries (LMICs).Methods: Hainan Island was taken as an example to explore the utilization of modern spatial access techniques under China’s specialized Three-Tier Health Care Delivery System. Healthcare institutions were first classified according to the three tiers. Then shortest travel time was calculated for each institution’s tier, overlapped to identify eight types of multilevel healthcare access zones. Spatial access to doctors based on the Enhanced Two-Step Floating Catchment Area Method was also calculated.Results: On Hainan Island, about 90% of the population lived within a 60-minute service range for Tier 3 (hospital) healthcare institutions, 80% lived within 30 minutes of Tier 2 (health centers), and 75% lived within 15 minutes of Tier 1 (clinics). Based on local policy, 76.36% of the population living in 48.52% of the area were able to receive timely services at all tiers of healthcare institutions. The weighted average access to doctors was 2.31 per thousand residents, but the regional disparity was large, with 64.66% being contributed by Tier 3 healthcare institutions.Conclusion: Spatial access to healthcare institutions on Hainan Island was generally good according to travel time and general abundance of doctors, but inequity between regions and imbalance between different healthcare institution tiers exist. Primary healthcare institutions, especially in Tier 2, should be strengthened.

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The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China

Cited by 23 publications

References 52 publications

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Spatial Accessibility of Primary Health Care in Rural Areas in Poland

An integrated analysis of spatial access to the three-tier healthcare delivery system in China: A case study of Hainan Island

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