Related Experiment Videos
Finding the medically underserved: a need to revise the federal definition
Journal of Health Care for the Poor and Underserved
|November 1, 1996
Summary
Urban community health centers (CHCs) serving primary service areas (PSAs) can qualify as medically underserved areas (MUAs). Poverty and infant mortality best predict medical underservice in urban settings.
Area of Science:
- Public Health
- Health Services Research
- Urban Health
Background:
- Assessed the relationship between urban community health center (CHC) primary service areas (PSAs) and federally defined medically underserved areas (MUAs).
- Identified federal guidelines most predictive of medical underservice.
- Statistically defined service areas using census tract penetration rates and the Index of Medical Underservice (IMU).
Discussion:
- Analyzed federal parameters including physician supply, poverty, elderly population, and infant mortality.
- Excluded census tracts with high concentrations of managed-care physicians for accurate MUA qualification.
- Found a strong association between tracts meeting both MUA and PSA criteria (p < 0.0001).
Key Insights:
- Poverty level and infant mortality were the most significant discriminating parameters for medical underservice.
- Federal indicators of demand (elderly population) and supply (physicians) were insufficient for urban neighborhood access issues.
- Urban CHC PSAs can align with MUA definitions when specific criteria are met.
Outlook:
- Explores alternative parameters as proxies for healthcare access and underserved populations in urban environments.
- Highlights the need for refined federal guidelines to accurately capture urban medical underservice.
- Suggests improved methodologies for defining and addressing healthcare access disparities in urban communities.