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The effect of subsidized primary car...

Cockley, David Edward.

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The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992.

Record Type:	Electronic resources : Monograph/item
Title/Author:	The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992./
Author:	Cockley, David Edward.
Description:	101 p.
Notes:	Source: Dissertation Abstracts International, Volume: 57-12, Section: B, page: 7477.
Contained By:	Dissertation Abstracts International57-12B.
Subject:	Health Sciences, Public Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9715793
ISBN:	059123646X

The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992.
Cockley, David Edward.

The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992. - 101 p.

Source: Dissertation Abstracts International, Volume: 57-12, Section: B, page: 7477.

Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 1996.

A study of subsidized primary care centers in West Virginia was made to determine if the presence of centers in underserved communities resulted in lower percentages of hospitalizations for six ambulatory care sensitive conditions. External subsidies supported an infrastructure of primary care centers in West Virginia's rural underserved communities. All centers provided a required core of basic services to residents regardless of their ability to pay. Centers varied in organizational type and comprehensiveness of services targeted at low socio-economic populations.

ISBN: 059123646XSubjects--Topical Terms:

1017659
Health Sciences, Public Health.

The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992.
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100 1 $a Cockley, David Edward. $3 1905446
245 1 4 $a The effect of subsidized primary care centers on avoidable hospitalizations in West Virginia communities during 1988-1992.
300 $a 101 p.
500 $a Source: Dissertation Abstracts International, Volume: 57-12, Section: B, page: 7477.
502 $a Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 1996.
520 $a A study of subsidized primary care centers in West Virginia was made to determine if the presence of centers in underserved communities resulted in lower percentages of hospitalizations for six ambulatory care sensitive conditions. External subsidies supported an infrastructure of primary care centers in West Virginia's rural underserved communities. All centers provided a required core of basic services to residents regardless of their ability to pay. Centers varied in organizational type and comprehensiveness of services targeted at low socio-economic populations.
520 $a A survey of center administrators and a retrospective review of state funding applications for 1988-1992 were used to develop a typology of the primary care centers in the state. Hospital discharge data by ZIP code of residence were used to evaluate whether residents proximate to subsidized primary care centers had better access measures than other underserved communities. The five-year average percentage of total hospitalizations for six avoidable diagnoses (asthma; chronic obstructive pulmonary disease; hypertension; angina; congestive heart failure; diabetes) was utilized as a measure of access to primary care.
520 $a The fifty-seven primary care centers active during 1988-1992 were clustered into four types: solo clinics; central clinics with satellites; hospital-run clinics; and multi-site primary care systems. Core primary care services were consistent across centers but there was variation in the comprehensiveness of services to low income populations.
520 $a Per capita income and proximity to a moderate-volume hospital were inversely associated with the percentage of total hospitalizations for avoidable conditions. No correlation was identified for avoidable hospitalizations and proximity of any subsidized primary care center nor proximity to centers with more comprehensive services.
520 $a Avoidable hospitalizations may reflect differences in health-seeking behavior of low socio-economic populations. Implementation of gatekeeping strategies and expansion of primary care networks would encourage a reduction in hospitalization rates. There may also be indirect incentives for the hospitalization of patients for conditions that could be maintained at the primary care level.
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