A new way to compare health systems: avoidable hospital conditions in Manhattan and Paris.
Based on a comparison of discharges for avoidable hospital conditions (AHCs), we find that Paris provides greater access to primary care than Manhattan. Age-adjusted AHC rates are more than 2.5 times as high in Manhattan as in Paris. In contrast, the difference in rates of hospital discharge for "marker conditions" are only about 20 percent higher in Manhattan. Rates of discharges for AHCs are higher among residents of low-income neighborhoods in both cities, but the disparity among high- and low-income neighborhoods is more than twice as great in Manhattan. Our analysis highlights the consequences of access barriers to care in Manhattan, particularly among vulnerable residents.
Gusmano
Michael K
MK
Columbia University, New York City, USA. mkg2104@columbia.edu
Rodwin
Victor G
VG
Weisz
Daniel
D
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000191:economics / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D017057:Medically Uninsured; D008875:Middle Aged; D009519:New York City; D010297:Paris; D011204:Poverty Areas; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D017211:Treatment Failure; D019037:Urban Health Services; D035862:Vulnerable Populations