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09-03-2023 | Care | Original Article

Social deprivation, the Area Deprivation Index, and emergency department utilization within a community-based primary and preventive care program at a Florida medical school

Authors: Mackenzie Mayhew, Alexa Denton, Anna Kenney, Jamie Fairclough, Anuj Ojha, Prasad Bhoite, Matthew T. Hey, Rupa Seetharamaiah, Shahab Shaffiey, Gregory W. Schneider

Published in: Journal of Public Health | Issue 5/2024

Abstract

Introduction

Higher Area Deprivation Index (ADI) scores, indicating higher social deprivation, have been associated with more frequent emergency department (ED) utilization. Access to clinical and social services can help prevent inappropriate ED use. A community-based medical school administering a primary and preventive care program focused on the social determinants of health (SDOH) tracks annual ED utilization by its households. This retrospective study determined household ADI scores and evaluated for associations with ED use.

Methods

The ADI uses 17 publicly available variables to assign composite scores of social deprivation at the block group level. The Green Family Foundation Neighborhood Health Education Learning Program at Florida International University provides outreach, clinical, and educational services to > 850 disadvantaged households. We conducted Poisson regression to evaluate the association between households’ ADI scores and self-reported ED utilization over 2 calendar years.

Results

For both the 2018 and 2019 cohorts, independent Poisson regression results indicate that ED visit count is significantly and inversely associated with ADI raw scores and deciles (p < 0.001).

Discussion

Based on findings from earlier studies, we had hypothesized a positive, yet reduced association between annual ED utilization and ADI level but surprisingly, we found an inverse association. The combination of providing primary care and connecting with social and behavioral health services as needed appeared to reverse the expected higher ED use at higher ADI scores.

Conclusion

Tracking of ED utilization in association with composite, area-based indices such as the ADI may prove useful for other clinical and community health endeavors focused on SDOH.

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Title: Social deprivation, the Area Deprivation Index, and emergency department utilization within a community-based primary and preventive care program at a Florida medical school
Authors: Mackenzie Mayhew
Alexa Denton
Anna Kenney
Jamie Fairclough
Anuj Ojha
Prasad Bhoite
Matthew T. Hey
Rupa Seetharamaiah
Shahab Shaffiey
Gregory W. Schneider
Publication date: 09-03-2023
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: Journal of Public Health / Issue 5/2024
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-023-01871-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Social deprivation, the Area Deprivation Index, and emergency department utilization within a community-based primary and preventive care program at a Florida medical school

Abstract

Introduction

Methods

Results

Discussion

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

Conclusion

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