Geographic information system reveals primary care needs of Hispanics
With Hispanics suffering from a number of health care disparities, it is important to identify geographic areas where unmet needs are the most acute. Using the Multiple Attribute Primary Care Targeting Strategy (MAPCATS) process is one way to do this, suggests a new study. Researchers found that the technique effectively identified geographic regions where increasing access to primary care services for the Hispanic community would have the greatest potential impact on health outcomes.
MAPCATS analyzed five key attributes describing the Hispanic population in Charlotte, North Carolina, which has the fourth fastest growing Hispanic community in the United States. The attributes were: socioeconomic status, population density, insurance status, patterns of emergency department (ED) use, and utilization of the primary care safety net. The researchers developed maps for each individual attribute, and then created a process using input from health providers and community members to blend these attributes into a composite map showing the community's overall primary care needs.
From the composite map, the researchers were able to identify areas to target interventions to increase primary care access for the Hispanic population in Charlotte. For example, one target area had no nearby safety-net clinic. Some other target areas had a safety-net clinic that primarily served black or white patients. Low-income uninsured patients or those with Medicaid insurance living in areas without an accessible safety net clinic were also more likely to receive care for primary care treatable conditions from a nearby ED.
The composite map will allow the research team to target specific areas within the community for interventions that improve access to primary care. In addition, the MAPCATS model can be used to assist policymakers looking to identify locations where increased access to primary care would most impact health outcomes and reduce the cost of medical care by reducing inappropriate use of emergency services. Finally, the composite maps can be monitored over time to measure changes in the community's patterns of health care access that result from the development of new clinics or other interventions that help patients see a primary care doctor when needed. The study was supported in part by the Agency for Healthcare Research and Quality (HS16023).
See "Geographic information system (GIS) demonstrating primary care needs for a transitioning Hispanic community," by Michael F. Dulin, M.D., Ph.D., Thomas M. Ludden, M.A., Hazel Tapp, Ph.D., and others in the January/February 2010 Journal of the American Board of Family Medicine, 23(1), pp. 109-120.
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