The Resource Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories : an analysis of the National Health Interview Survey Data (1999-2011), Rohan Jayantha Bandara

Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories : an analysis of the National Health Interview Survey Data (1999-2011), Rohan Jayantha Bandara

Label
Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories : an analysis of the National Health Interview Survey Data (1999-2011)
Title
Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories
Title remainder
an analysis of the National Health Interview Survey Data (1999-2011)
Statement of responsibility
Rohan Jayantha Bandara
Creator
Contributor
Author
Degree supervisor
Subject
Genre
Language
eng
Summary
In the United States (US), where access to and affordability of healthcare remains a critical challenge, emergency departments (ED) have increasingly served as a source for primary care and a portal to hospital admissions. Although barriers to timely primary care and lack of insurance are considered influential factors, the inter-relationship between these issues and ED use is not well-understood. We, therefore, examined the relationship between self-reported insurance status, perceived barriers and ED use among non-institutionalized US adults. We analyzed data from 378,502 participants of the 1999 to 2011 National Health Interview Survey. The following were considered as barriers to timely primary care as experienced during the past year: unable to get through on telephone, unable to obtain appointment soon enough, long wait in the physician's office, limited clinic hours, and lack of transportation. Individuals were classified by source of insurance into Private, Medicare, Medicaid, Other insurance, and No insurance. National estimates were obtained using appropriate sampling weights. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for [greater then/equal to] 1 ED use and to test for the interaction between self-reported barriers and source of insurance. Overall, 10.0% of adults had [greater then/equal to] 1 barrier to care and 20.2% reported [greater then/equal to] 1 ED visit in the past year. Insurance profile was as follows: Private (57.8%), Medicare (17.7%), Uninsured (16.3%), Medicaid (5.0%), and Other Insurance (2.6%). Compared to those without any barrier, adults who experienced [greater then/equal to] 1 barriers were more likely to report [greater then/equal to] 1 ED visits in the past year (32.6% vs. 18.8%). In multivariate models that included both barriers and source of insurance, the odds of an ED visit was greater among adults with [greater then/equal to] 1 vs. no barriers (OR [95%CI] - 2.01 [1.95-2.07]), and varied across source of insurance (OR [95%CI]-Private: reference; Medicare: 1.76 [1.72 - 1.81]; Medicaid: 3.11 [3.00-3.23]; Other: 1.83 [1.73 - 1.94]; Uninsured: 1.26 [1.23 - 1.30]). The magnitude of association between barriers and ED use varied across insurance categories. Among non-institutionalized adults in the US, the source of insurance was seen to influence the association between perceived barriers to timely care and ED use. Further analyses are planned to determine whether this relationship persists after controlling for socio-demographic and clinical characteristics
Cataloging source
UMK
http://library.link/vocab/creatorName
Bandara, Rohan Jayantha
Degree
M.S.
Dissertation note
(School of Medicine).
Dissertation year
2014.
Granting institution
University of Missouri-Kansas City,
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
  • theses
http://library.link/vocab/relatedWorkOrContributorName
Venkitachalam, Lakshmi
http://library.link/vocab/subjectName
  • Hospitals
  • Primary health care
  • Emergency Service, Hospital
Label
Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories : an analysis of the National Health Interview Survey Data (1999-2011), Rohan Jayantha Bandara
Instantiates
Publication
Note
  • "A thesis in Bioinformatics."
  • Advisor: Lakshmi Venkitachalam
  • Vita
Antecedent source
not applicable
Bibliography note
Includes bibliographical references (pages 34-37)
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Color
black and white
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Contents
Introduction -- Review of literature -- Methodology -- Results -- Discussion
Control code
909784112
Dimensions
unknown
Extent
1 online resource (38 pages)
File format
one file format
Form of item
online
Level of compression
mixed
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Quality assurance targets
not applicable
Specific material designation
remote
System control number
(OCoLC)909784112
System details
  • The full text of the thesis is available as an Adobe Acrobat .pdf file; Adobe Acrobat Reader required to view the file
  • Mode of access: World Wide Web
Label
Understanding the relationship between barriers to timely primary care and emergency department utilization across insurance categories : an analysis of the National Health Interview Survey Data (1999-2011), Rohan Jayantha Bandara
Publication
Note
  • "A thesis in Bioinformatics."
  • Advisor: Lakshmi Venkitachalam
  • Vita
Antecedent source
not applicable
Bibliography note
Includes bibliographical references (pages 34-37)
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Color
black and white
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Contents
Introduction -- Review of literature -- Methodology -- Results -- Discussion
Control code
909784112
Dimensions
unknown
Extent
1 online resource (38 pages)
File format
one file format
Form of item
online
Level of compression
mixed
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Quality assurance targets
not applicable
Specific material designation
remote
System control number
(OCoLC)909784112
System details
  • The full text of the thesis is available as an Adobe Acrobat .pdf file; Adobe Acrobat Reader required to view the file
  • Mode of access: World Wide Web

Library Locations

  • Ellis LibraryBorrow it
    1020 Lowry Street, Columbia, MO, 65201, US
    38.944491 -92.326012
  • Engineering Library & Technology CommonsBorrow it
    W2001 Lafferre Hall, Columbia, MO, 65211, US
    38.946102 -92.330125
  • Fisher Delta Research CenterBorrow it
    2-64 Agricultural Bldg, Columbia, MO, 65201, US
    38.958397 -92.303491
  • Geological Sciences LibraryBorrow it
    201 Geological Sciences, Columbia, MO, 65211, US
    38.947375 -92.329062
  • J. Otto Lottes Health Sciences LibraryBorrow it
    1 Hospital Dr, Columbia, MO, 65201, US
    38.939544 -92.328377
  • Journalism LibraryBorrow it
    102 Reynolds Jrnlism Institute, Columbia, MO, 65211, US
    38.947290 -92.328025
  • Mathematical Sciences LibraryBorrow it
    104 Ellis Library, Columbia, MO, 65201, US
    38.944377 -92.326537
  • University ArchivesBorrow it
    Columbia, MO, 65201, US
  • University Archives McAlester AnnexBorrow it
    703 Lewis Hall, Columbia, MO, 65211, US
    38.934630 -92.342290
  • University of Missouri Libraries DepositoryBorrow it
    2908 Lemone Blvd, Columbia, MO, 65211, US
    38.919360 -92.291620
  • Zalk Veterinary Medical LibraryBorrow it
    Veterinary Medicine West, Columbia, MO, 65211, US
    38.941099 -92.317911
Processing Feedback ...