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Medical Care Research and Review, Vol. 60, No. 4, 468-495 (2003)
DOI: 10.1177/1077558703257369
© 2003 SAGE Publications

Hazards of Hospitalization for Ambulatory Care Sensitive Conditions among Older Women: Evidence of Greater Risks for African Americans and Hispanics

James N. Laditka

University of South Carolina

Hospitalization for Ambulatory Care Sensitive conditions (ACSH) has been widely accepted as an indicator of the accessibility and overall performance of primary health care. Previous studies have found conflicting evidence about ACSH disparities associated with race or ethnicity for older persons. This study estimates discrete-time ACSH hazards for women aged 69 or older, using longitudinal data with multivariate controls. Data are from the 1984 to 1990 Longitudinal Study of Aging, linked with Medicare claims. The multivariate results are adjusted for age, education, insurance and marital status, and other factors associated with health status and primary care access, and also for important indicators of need that include self-rated health, comorbidities, physical impairments, and previous hospitalizations. Many of these factors are permitted to vary across time for each individual, thus limiting measurement error. Results suggest that older African American and Hispanic women have markedly higher ACSH risks than older non-Hispanic white women.

Key Words: Ambulatory Care Sensitive conditions • preventable hospitalization • health care access • primary health care • health care disparities


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Z. Ansari, J. N. Laditka, and S. B. Laditka
Access to health care and hospitalization for ambulatory care sensitive conditions.
Med Care Res Rev, December 1, 2006; 63(6): 719 - 741.
[Abstract] [PDF]