title: Disparities in Potentially Preventable Hospitalizations: Near-National Estimates for Hispanics.
abstract: To obtain near-national rates of potentially preventable hospitalization (PPH)-a marker of barriers to outpatient care access-for Hispanics; to examine their differences from other race-ethnic groups and by Hispanic national origin; and to identify key mediating factors.
  
  
  
  Data from all-payer inpatient discharge databases for 15 states accounting for 85 percent of Hispanics nationally.
  
  
  
  Combining counts of inpatient discharges with census population for adults aged 18 and older, we estimated age-sex-adjusted PPH rates. We examined county-level variation in race-ethnic disparities in these rates to identify the mediating role of area-level indicators of chronic condition prevalence, socioeconomic status (SES), health care access, acculturation, and provider availability.
  
  
  
  Age-sex-adjusted PPH rates were 13 percent higher among Hispanics (1,375 per 100,000 adults) and 111 percent higher among blacks (2,578) compared to whites (1,221). Among Hispanics, these rates were relatively higher in areas with predominantly Puerto Rican and Cuban Americans than in areas with Hispanics of other nationalities. Small area variation in chronic condition prevalence and SES fully accounted for the higher rates among Hispanics, but only partially among blacks.
  
  
  
  Hispanics and blacks face higher barriers to outpatient care access; the higher barriers among Hispanics (but not blacks) seem mediated by SES, lack of insurance, cost barriers, and limited provider availability.
authors.affiliation: Section of General Internal Medicine, Boston Medical Center, Boston, MA.
authors.forename: Chen
authors.initials: C
authors.lastname: Feng
authors.affiliation: Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Paasche-Orlow
authors.affiliation: Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.|VA Boston Healthcare System, Boston, MA.
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Kressin
authors.affiliation: MedStar Washington Hospital Center, Washington, DC.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Rosen
authors.affiliation: Department of Medicine, University of California-San Francisco, San Francisco, CA.
authors.forename: Lenny
authors.initials: L
authors.lastname: López
authors.affiliation: Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.|Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, MA.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Section of General Internal Medicine, Boston Medical Center, Boston, MA.
authors.forename: Meng-Yun
authors.initials: MY
authors.lastname: Lin
authors.affiliation: Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.|VA Boston Healthcare System, Boston, MA.
authors.forename: Amresh D
authors.initials: AD
authors.lastname: Hanchate
mesh_terms: D000069:Acculturation; D000208:Acute Disease; D001741:Black or African American; D002908:Chronic Disease / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Hispanics; ambulatory care sensitive condition admissions; disparities; potentially preventable hospitalizations