Does Spatial Access to Primary Care Affect Emergency Department Utilization for Nonemergent Conditions?

Area of Science:

• Public Health
• Health Services Research
• Spatial Epidemiology

Background:

• Emergency department (ED) utilization for preventable conditions is a significant public health concern.
• Understanding the role of spatial access to care is crucial for reducing unnecessary ED visits.
• Existing measures may not fully capture local variations in access.

Purpose of the Study:

• To investigate how individual- and neighborhood-level spatial access to care influences the use of EDs for preventable conditions.
• To implement novel local spatial access measures for this analysis.
• To identify factors associated with higher odds of preventable ED use.

Main Methods:

• Utilized multilevel logit regression to model the relationship between patient and neighborhood attributes and preventable ED use.
• Employed emergency department admissions data from four Chicago hospitals (2007-2011).
• Generated spatial access to care indices using ArcGIS and extracted values at ZIP code centroids.

Main Results:

• Patients residing in medically underserved areas (MUAs) showed increased odds of preventable ED use.
• Lower spatial access to primary care clinics was associated with higher odds of preventable ED utilization.
• Sociodemographic factors, such as gender and race, also played a role.

Conclusions:

• Preventable ED use is linked to both sociodemographic characteristics and spatial access to primary care services.
• Local measures of spatial accessibility offer a promising approach for analyzing preventable ED use.
• Findings highlight the need to improve primary care access in underserved areas to reduce ED burden.