Table 2.
Associations between Primary Care Physician Access and Potentially Avoidable Hospitalization Rates
| OLS Model All ZCTAs | Spatial Model All ZCTAs | OLS Model All ZCTAs | Spatial Model All ZCTAs | Spatial Model All ZCTAs | Spatial Model Excluding Edge‐ZCTAs | |
|---|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | (6) | |
| Bounded‐area measure of primary care access | −0.165* (0.088) | −0.042 (0.068) | ||||
| Geographic measure of primary care accessibility | −0.455*** (0.148) | −0.212** (0.088) | −0.201** (0.092) | −0.329*** (0.101) | ||
| Bounded‐area measure of non‐physician clinician access | −0.025 (0.059) | 0.008 (0.065) | ||||
| Spatial lag parameter (lambda) | 0.558*** (0.033) | 0.548*** (0.034) | 0.548*** (0.034) | 0.169*** (0.038) | ||
| Average direct effect of geographic PCP accessibility | −0.045 | −0.228 | −0.217 | −0.331 | ||
| Cumulative indirect effect of geographic PCP accessibility | −0.049 | −0.241 | −0.229 | −0.065 | ||
| Sample size | 843 | 843 | 843 | 843 | 843 | 717 |
The dependent variable is the log of (1 plus the count of avoidable hospitalizations) divided by 1,000 persons aged 65 years and older in the ZCTA. All models include measures of the shares of the population aged 65–69, 70–74, 75–79, 80–84, and 85 years and older, female, African American, and of Hispanic ethnicity, population density, the share of the population residing in an urban area, the unemployment rate, median household income, the share of the population with incomes below 100% of the federal poverty level, the share of the population aged 25 years and older without a high school diploma, the share of the elderly population living alone, and the share of the population speaking English less than “very well,” the number of short‐term acute hospital beds per 1,000 persons, the Medicare Advantage penetration rate, the number of minutes to the closest hospital, and the share the population that resided in any primary care Health Professional Shortage Area or HPSA. Standard errors are reported in parentheses. OLS models report standard errors clustered at the level of the county or county equivalent. Statistical significance is indicated by * (0.1 level), ** (0.05 level), or *** (0.01 level).