社区卫生中心在减少初级保健空间可及性方面种族差异中的作用。
The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care.
作者信息
Seymour Jane W, Polsky Daniel E, Brown Elizabeth J, Barbu Corentin M, Grande David
机构信息
1 Boston University School of Public Health, Boston, MA, USA.
2 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Prim Care Community Health. 2017 Jul;8(3):147-152. doi: 10.1177/2150131917699029. Epub 2017 Mar 23.
INTRODUCTION
Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities.
METHODS
We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility.
RESULTS
Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7.84, P = 0.001) were more likely to be near a CHC and those with moderate rates of uninsurance (10%-19% vs <10%, OR = 0.42, P = .045) were less likely. Racial composition was not associated with proximity. Tracts close to a CHC were less likely (OR = 0.11, P < .0001) to be in a low access area. This association did not differ based on racial composition.
DISCUSSION
Although CHCs were more likely to be in areas with a greater fraction of racial minorities, location was more strongly influenced by public insurance rates. CHCs reduced the likelihood of being in low access areas but the effect did not vary by tract racial composition.
引言
少数族裔更有可能居住在初级医疗服务短缺地区。我们试图了解社区卫生中心（CHC）在减少差异方面的作用。
方法
我们对一个城市地区的所有初级医疗服务机构进行了调查，确定了低可达性地区，并研究了社区卫生中心如何影响空间可达性。
结果
公共保险率较高的普查区（≥40%对<10%，优势比[OR]=31.06，P<.001；30%-39%对10%，OR=7.84，P=0.001）更有可能靠近社区卫生中心，而未参保率中等的普查区（10%-19%对<10%，OR=0.42，P=.045）则可能性较小。种族构成与距离无关。靠近社区卫生中心的普查区处于低可达性地区的可能性较小（OR=0.11，P<.0001）。这种关联在不同种族构成之间没有差异。
讨论
虽然社区卫生中心更有可能位于少数族裔比例较高的地区，但位置受公共保险率的影响更大。社区卫生中心降低了处于低可达性地区的可能性，但这种影响在不同普查区的种族构成之间没有差异。
Zotero 插件