• Low SES predicts higher hospital admission rates
Hospital Stays among People Living in the Poorest Communities, 2006. HCUP Statistical Brief #73. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb73.pdf [May 2009]
Low socioeconomic status is associated with higher hospital admission rates, likely due to lower use of routine and preventive
healthcare services among poorer individuals that could prevent hospitalization, according to the Agency for Healthcare Research
and Quality (AHRQ).
Data from the Healthcare Cost and Utilization Project (HCUP) compared hospital stays of patients from the poorest communities
with other communities. Communities with a median household income of less than $38,000 were classified as the poorest communities
in HCUP databases in 2006. Understanding the differences in hospital utilization characteristics by community-level income
can shed light on healthcare disparities. HCUP examined hospital utilization characteristics, including volume, cost, underlying causes, most common procedures and
expected primary payer.
Statistical findings showed the rate of hospitalization among those living in the poorest areas was 22% higher compared with
people living in wealthier communities, and the rate of hospital stays among 45- to 64-year-olds was nearly 50% higher for
people in the lowest-income communities.
• Update: Massachusetts model for universal care
Health Affairs. doi:10.1377/hlthaff.28.4.w578 [May 28, 2009]
An annual survey on Massachusetts' health reform legislation shows that although coverage has improved since 2006, access
and affordability of care has eroded due to rising health costs and a shortage of primary care physicians.
Near-universal health insurance coverage and improved access to affordable high-quality care were the goals of the Massachusetts
model, with shared individual, employer and government responsibilities. Elements of the reform include Medicaid expansions,
subsidized private insurance coverage, a purchasing pool, required action for employers and an individual mandate. These elements
were responsible for lowering the uninsured rate for all Massachusetts residents to 2.6% in the summer of 2008.
However, by fall of 2008, access and affordability of care had eroded. There weren't enough willing physicians to care for
the higher numbers of newly insured.
One in five adults said they had been told in the last 12 months that a doctor or clinic was not accepting new patients or
would not see patients with their type of insurance.
In addition, the difficulty in finding a provider was more prevalent among lower-income adults (29%) than higher-income adults
(15%), and for those with public and other coverage (32%) than those with private coverage (16%).
Researchers found consistent yearly increases in the percentage of residents who said they had regular access to a provider,
but concluded that these initial gains in access to care had begun to erode by fall 2008.
