BACKGROUND: Studies in the United States have demonstrated that rates of hospitalization for conditions sensitive to primary care are related to socioeconomic factors. Our objective was to identify those sociodemographic and primary care factors associated with pediatric hospitalization for ambulatory care-sensitive conditions, in a country (Spain) with a health system that provides universal coverage. METHODS: Cross-sectional survey of 504 children hospitalized in a District General Hospital in Valencia, Spain. Data were gathered on sociodemographic variables, type of physician providing primary care and ambulatory care use prior to hospitalization. Analysis consisted of bivariate statistical tests and logistic regression techniques. RESULTS: Children who were under 2 years old and female were at significantly higher risk for hospitalization due to ambulatory care-sensitive conditions. Socioeconomic variables, type of physician or a previous visit to primary care services were not associated with a different risk of hospitalization due to these conditions. CONCLUSION: Characteristics unrelated to difficulties in access, or to type of provider, influence the risk of hospital admissions for conditions that could be prevented or managed without hospitalization. More specific classification of conditions potentially could be useful for determining which factors of structure or process of health services are related to hospitalization.
BACKGROUND: Studies in the United States have demonstrated that rates of hospitalization for conditions sensitive to primary care are related to socioeconomic factors. Our objective was to identify those sociodemographic and primary care factors associated with pediatric hospitalization for ambulatory care-sensitive conditions, in a country (Spain) with a health system that provides universal coverage. METHODS: Cross-sectional survey of 504 children hospitalized in a District General Hospital in Valencia, Spain. Data were gathered on sociodemographic variables, type of physician providing primary care and ambulatory care use prior to hospitalization. Analysis consisted of bivariate statistical tests and logistic regression techniques. RESULTS:Children who were under 2 years old and female were at significantly higher risk for hospitalization due to ambulatory care-sensitive conditions. Socioeconomic variables, type of physician or a previous visit to primary care services were not associated with a different risk of hospitalization due to these conditions. CONCLUSION: Characteristics unrelated to difficulties in access, or to type of provider, influence the risk of hospital admissions for conditions that could be prevented or managed without hospitalization. More specific classification of conditions potentially could be useful for determining which factors of structure or process of health services are related to hospitalization.
Authors: Leiyu Shi; James Macinko; Barbara Starfield; Robert Politzer; John Wulu; Jiahong Xu Journal: Am J Public Health Date: 2005-04 Impact factor: 9.308