Date of Award

2010

Degree Type

Dissertation

Department

Maxine Goodman Levin College of Urban Affairs

First Advisor

Bowen, William

Subject Headings

Health services accessibility -- Ohio, People with disabilities -- Ohio, Public health -- Ohio, Medical care -- Utilization -- Ohio, spatial accessibility, disabilities, public health, primary care, health care utilization, health status, geographic information system

Abstract

The purpose of this cross-sectional analysis was to determine the importance of spatial accessibility to health care services utilization and to the health status of persons with disabilities. This study utilizes two datasets (Survey of Access to Outpatient Medical Service in the Rural Southeast and Ohio Family Health Survey) to analyze. ArcGIS 9.2 was use to measure spatial accessibility to health care services. Bivariate analysis for health services utilization and health status included t-tests, and Chi-square, as appropriate for the level of measurement. Logistic regression models identified for the three outcomes (health care visit, regular check up visit, and perceived poor health status). The multivariate analyses of "Survey of Access to Outpatient Medical Service in the Rural Southeast" dataset revealed that those residing within an area that had a higher primary physician to population ratio were less likely to have made a health care services visit in the past year. Perceived travel time was significantly associated with poor health status adults who had to drive longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive. The analyses of the "Ohio Family Health Survey" dataset indicate that participants of the survey who resided within areas that had a higher primary care physician to population ratio were less likely to perceive themselves to be in poor health. Likewise, those residing in areas that had a hospital located within a 30-minute commute were also less likely to report being in poor health. Further analyses of the Ohio Family Health Survey dataset, which is comprised of data collected from urban and rural areas, revealed that those driving longer to access health care services were more likely to perceive themselves to be in poor health compared to adults who were faced with a shorter drive in urban area. The model of rural areas revealed that those residing within an area that had a higher prima

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