Healthcare usage is influenced by a number of factors, including health care facilities and ambulatory care services; transportation infrastructure; demographics; and socioeconomic status. Among these factors, healthcare access and use is often most closely associated with income. People with higher incomes spend more on out-of-pocket medical expenditures, which include direct payments to providers and cost-sharing. However, a small percentage of families in any given year account for a large proportion of total family spending.
Health care utilization is influenced by a number of factors, such as access to healthcare services and ambulatory care, the ability to obtain prescription drugs, and the willingness of patients to seek treatment. In rural areas, social stigma and privacy concerns are more likely to discourage healthcare utilization. Moreover, lack of internet connectivity and slow internet speeds can limit telehealth services.
Using longitudinal business data from the National Establishment Time-Series, this cross-sectional study examines change in the presence of ambulatory care facilities and pharmacies and drugstores in census tracts (CTs) across the United States. CTs were categorized as never having any of these facilities, gaining them at some point, losing them, or consistently having them between 2000 and 2014. Multinomial logistic regression models estimated associations between changes in neighborhood-level demographic and socioeconomic characteristics and change in health care facility presence.
The authors acknowledge the limitations of this study, including the reliance on data from a single source and the categorization of race and Hispanic ethnicity used in the Office of Management and Budget (OMB) standard for collecting and reporting data. This category reflects legislatively-based priorities for collecting and reporting data on certain groups, but may not be the only analytic group useful to health care quality improvement efforts. healthcare usage by location demographic
