title: Preventable hospitalizations: does rurality or non-physician clinician supply matter?
abstract: This study examines the relationship between rurality as well as the proportion of non-physician clinicians and county rates of ambulatory care sensitive hospitalizations (ACSHs) for pediatric, adult and elderly populations in Nebraska. The study design was a cross-sectional observational study of county level factors that affect the county level rates of ACSHs using Poisson regression models. Rural (non-metro) counties have significantly higher ACSHs for both pediatric and adult population, but not for the elderly. Frontier counties have significantly higher adult ACSHs. The proportion of primary care providers who are non-physician clinicians does not have a significant association with ACSHs for any of the age groups. The results indicate that rurality may have a greater impact on pediatric and adult ACSHs and the proportion of NPCs in the primary care provider workforce does not significantly impact ACSH rates.
authors.affiliation: Health Services Research and Administration, University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, USA. pnayar@unmc.edu
authors.forename: Preethy
authors.initials: P
authors.lastname: Nayar
authors.forename: Anh T
authors.initials: AT
authors.lastname: Nguyen
authors.forename: Bettye
authors.initials: B
authors.lastname: Apenteng
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D003430:Cross-Sectional Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009329:Nebraska; D009722:Nurse Practitioners / Q000600:supply & distribution*; D010823:Physician Assistants / Q000600:supply & distribution*; D010820:Physicians / Q000600:supply & distribution*; D058007:Physicians, Primary Care / Q000600:supply & distribution*; D019035:Rural Health Services / Q000706:statistics & numerical data; D000078329:Workforce