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The Association of Mobility, Social Deprivation, and Pediatric Primary Care Outcomes in Community Health Centers.
Lucas, Jennifer A; Hsu, Audree; Heintzman, John; Bailey, Steffani R; Suglia, Shakira F; Bazemore, Andrew; Giebultowicz, Sophia; Marino, Miguel.
Afiliação
  • Lucas JA; Department of Family Medicine, Oregon Health & Science University, Portland, OR. Electronic address: lucasje@ohsu.edu.
  • Hsu A; California University of Science and Medicine, Colton, CA.
  • Heintzman J; Department of Family Medicine, Oregon Health & Science University, Portland, OR.
  • Bailey SR; Department of Family Medicine, Oregon Health & Science University, Portland, OR.
  • Suglia SF; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Bazemore A; American Board of Family Medicine, Lexington, KY.
  • Giebultowicz S; OCHIN, Inc, Portland, OR.
  • Marino M; Department of Family Medicine, Oregon Health & Science University, Portland, OR.
J Pediatr ; 259: 113465, 2023 08.
Article em En | MEDLINE | ID: mdl-37179014
OBJECTIVE: To examine how social deprivation and residential mobility are associated with primary care use in children seeking care at community health centers (CHCs) overall and stratified by race and ethnicity. STUDY DESIGN: We used electronic health record open cohort data from 152 896 children receiving care from 15 U S CHCs belonging to the OCHIN network. Patients were aged 3-17 years, with ≥2 primary care visits during 2012-2017 and had geocoded address data. We used negative binomial regression to calculate adjusted rates of primary care encounters and influenza vaccinations relative to neighborhood-level social deprivation. RESULTS: Higher rates of clinic utilization were observed for children who always lived in highly deprived neighborhoods (RR = 1.11, 95% CI = 1.05-1.17) and those who moved from low-to-high deprivation neighborhoods (RR = 1.05, 95% CI = 1.01-1.09) experienced higher rates of CHC encounters compared with children who always lived in the low-deprivation neighborhoods. This trend was similar for influenza vaccinations. When analyses were stratified by race and ethnicity, we found these relationships were similar for Latino children and non-Latino White children who always lived in highly deprived neighborhoods. Residential mobility was associated with lower rates of primary care. CONCLUSIONS: These findings suggest that children living in or moving to neighborhoods with high levels of social deprivation used more primary care CHC services than children who lived in areas with low deprivation, but moving itself was associated with less care. Clinician and delivery system awareness of patient mobility and its impacts are important to addressing equity in primary care.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Influenza Humana Tipo de estudo: Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Influenza Humana Tipo de estudo: Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article