Abstract
Residential segregation is associated geographic disparities in access to care, but its impact on local health care policy, including public hospitals, is unknown. We examined the effects of racial residential segregation on U.S. urban public hospital closures from 1987 to 2007, controlling for hospital, market, and policy characteristics. We found that a high level of residential segregation moderated the protective effects of Black population composition, such that a high level of residential segregation, in combination with a high percentage of poor residents, conferred a higher likelihood of hospital closure. More segregated and poorer communities face disadvantages in access to care that may be compounded as a result of instability in the health care safety net. Policy makers should consider the influence of social factors such as residential segregation on the allocation of the safety net resources.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 243-260 |
| Number of pages | 18 |
| Journal | Medical Care Research and Review |
| Volume | 71 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2014 |
| Externally published | Yes |
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Keywords
- hospital closures and conversions
- public hospitals
- residential segregation
- safety net
ASJC Scopus subject areas
- Health Policy
- Medicine(all)
Cite this
Residential segregation and the survival of U.S. urban public hospitals. / Ko, Michelle J; Needleman, Jack; Derose, Kathryn Pitkin; Laugesen, Miriam J.; Ponce, Ninez A.
In: Medical Care Research and Review, Vol. 71, No. 3, 2014, p. 243-260.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Residential segregation and the survival of U.S. urban public hospitals
AU - Ko, Michelle J
AU - Needleman, Jack
AU - Derose, Kathryn Pitkin
AU - Laugesen, Miriam J.
AU - Ponce, Ninez A.
PY - 2014
Y1 - 2014
N2 - Residential segregation is associated geographic disparities in access to care, but its impact on local health care policy, including public hospitals, is unknown. We examined the effects of racial residential segregation on U.S. urban public hospital closures from 1987 to 2007, controlling for hospital, market, and policy characteristics. We found that a high level of residential segregation moderated the protective effects of Black population composition, such that a high level of residential segregation, in combination with a high percentage of poor residents, conferred a higher likelihood of hospital closure. More segregated and poorer communities face disadvantages in access to care that may be compounded as a result of instability in the health care safety net. Policy makers should consider the influence of social factors such as residential segregation on the allocation of the safety net resources.
AB - Residential segregation is associated geographic disparities in access to care, but its impact on local health care policy, including public hospitals, is unknown. We examined the effects of racial residential segregation on U.S. urban public hospital closures from 1987 to 2007, controlling for hospital, market, and policy characteristics. We found that a high level of residential segregation moderated the protective effects of Black population composition, such that a high level of residential segregation, in combination with a high percentage of poor residents, conferred a higher likelihood of hospital closure. More segregated and poorer communities face disadvantages in access to care that may be compounded as a result of instability in the health care safety net. Policy makers should consider the influence of social factors such as residential segregation on the allocation of the safety net resources.
KW - hospital closures and conversions
KW - public hospitals
KW - residential segregation
KW - safety net
UR - http://www.scopus.com/inward/record.url?scp=84899871057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899871057&partnerID=8YFLogxK
U2 - 10.1177/1077558713515079
DO - 10.1177/1077558713515079
M3 - Review article
C2 - 24362646
AN - SCOPUS:84899871057
VL - 71
SP - 243
EP - 260
JO - Medical Care Research and Review
JF - Medical Care Research and Review
SN - 1077-5587
IS - 3
ER -