Social vulnerability, medical care access and asthma related emergency department visits and hospitalization: An observational study

Authors

Sandeep S. Nayak, Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, NY 10029, USA; Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, CT 06610, USA. Electronic address: dr.sandeepnayak@gmail.com.
Rachana Borkar, Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, NY 10029, USA. Electronic address: Rachanaborkar22@gmail.com.Follow
Sherief Ghozy, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC program), Oxford University, UK. Electronic address: sherief_ghozy@yahoo.com.
Kwame Agyeman, Department of Internal Medicine, Loma Linda University Medical Center, CA 92354, USA. Electronic address: kagyeman2012@gmail.com.
Mohammed T. Al-Juboori, Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, NY 10029, USA. Electronic address: aljubom@nychhc.org.
Jaffer Shah, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: jaffer.shah@drexel.edu.
Michael T. Ulrich, Department of Internal Medicine, Loma Linda University Medical Center, CA 92354, USA; Department of Internal Medicine, Riverside University Health System, CA 92555, USA. Electronic address: m.ulrich@ruhealth.org.

Document Type

Article

Publication Title

Heart & lung : the journal of critical care

Abstract

BACKGROUND: The Social Vulnerability Index (SVI) is a publicly available dataset to identify communities in greatest need of resources. OBJECTIVE: To examine the utility of using the county-level SVI as predictors of asthma-related outcomes. METHODS: We used the American Community Survey-derived SVI and the National Environmental Public Health Tracking Network - Query Tool to retrieve data for all counties with available SVI data and at least one matched outcome of interest. Then, we tested SVI as a predictor for emergency department visits (EDV) and hospitalizations, with investigating disparities in primary care physician (PCP) density and emergency department physicians (EDP) density. Linear and logistic regression models were used. RESULTS: Compared to counties of the lowest SVI quartile, counties of mid-low, mid-high, and highest SVI quartiles had 1%, 4%, and 5% higher odds of asthma-related EDV per 10,000 population, respectively, and 4%, 21%, and 24% higher odds of asthma-related hospitalization per 10,000 population, respectively. Moreover, the data showed an apparent resources mismatch between the EDP densities per 10,000 populations and the SVI quartiles, and the effect of the county level SVI on the asthma-related EDV and hospitalization is not strongly affected by PCP or EDP densities. CONCLUSION: The counties with the highest SVI -and the most vulnerable to asthma hazards- have a lower coverage of PCP and EDP. Interventions directed to address persistent social vulnerability would offer the opportunity of primary prevention with less exhaustion for the medical resources.

First Page

140

Last Page

145

DOI

10.1016/j.hrtlng.2022.04.017

Publication Date

1-1-2022

Recommended Citation

Nayak, Sandeep S.; Borkar, Rachana; Ghozy, Sherief; Agyeman, Kwame; Al-Juboori, Mohammed T.; Shah, Jaffer; and Ulrich, Michael T., "Social vulnerability, medical care access and asthma related emergency department visits and hospitalization: An observational study" (2022). All Research. 64.
https://scholar.bridgeporthospital.org/all_research/64

Identifier

35588567 (pubmed); 10.1016/j.hrtlng.2022.04.017 (doi); S0147-9563(22)00106-6 (pii)