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Cited by 30Health disparities and outcomesUrban, Neighborhood, and Segregation StudiesPublic Health and Social Inequalities

The DOI matches its Crossref record; 32 of the 34 references it cites were found in a registry or an index.

The Association Between Neighborhood Socioeconomic and Housing Characteristics with Hospitalization: Results of a National Study of Veterans

Open access
Hatef, Elham, Kharrazi, Hadi, Nelson, Karin, Sylling, Philip, Ma, Xiaomeng, Lasser, Elyse C., Searle, Kelly M., Predmore, Zachary, Batten, Adam J., Curtis, Idamay, Fihn, Stephan, Weiner, Jonathan P.·2019·The Journal of the American Board of Family Medicine
DOI 10.3122/jabfm.2019.06.190138
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Abstract

BACKGROUND: Social determinants of health (SDOH) have an inextricable impact on health. If remained unaddressed, poor SDOH can contribute to increased health care utilization and costs. We aimed to determine if geographically derived neighborhood level SDOH had an impact on hospitalization rates of patients receiving care at the Veterans Health Administration's (VHA) primary care clinics. METHODS: In a 1-year observational cohort of veterans enrolled in VHA's primary care medical home program during 2015, we abstracted data on individual veterans (age, sex, race, Gagne comorbidity score) from the VHA Corporate Data Warehouse and linked those data to data on neighborhood socioeconomic status (NSES) and housing characteristics from the US Census Bureau on census tract level. We used generalized estimating equation modeling and spatial-based analysis to assess the potential impact of patient-level demographic and clinical factors, NSES, and local housing stock (ie, housing instability, home vacancy rate, percentage of houses with no plumbing, and percentage of houses with no heating) on hospitalization. We defined hospitalization as an overnight stay in a VHA hospital only and reported the risk of hospitalization for veterans enrolled in the VHA's primary care medical home clinics, both across the nation and within 1 specific case study region of the country: King County, WA. RESULTS: Nationally, 6.63% of our veteran population was hospitalized within the VHA system. After accounting for patient-level characteristics, veterans residing in census tracts with a higher NSES index had decreased odds of hospitalization. After controlling all other factors, veterans residing in census tracts with higher percentage of houses without heating had 9% (Odds Ratio, 1.09%; 95% CI, 1.04 to 1.14) increase in the likelihood of hospitalization in our regional Washington State analysis, though not our national level analyses. CONCLUSIONS: Our results present the impact of neighborhood characteristics such as NSES and lack of proper heating system on the likelihood of hospitalization. The application of placed-based data at the geographic level is a powerful tool for identification of patients at high risk of health care utilization.

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  • Health and healthcare utilization are shaped by social determinants of health (SDOH) such as food security, housing stability, and transportation access.

    “A compelling body of evidence demonstrates that health and healthcare utilization are shaped by social determinants of health (SDOH), such as food security, housing stability, and transportation access.1–3”

    From Documentation and review of social determinants of health data in the EHR: measures and associated insights (2021) · cites this paper as [2]

    The Abstract says SDOH affect health and healthcare utilization, and links housing instability to poorer healthcare access and greater acute-care use. Study Limitations identifies transportation availability as likely to affect access and utilization, but says it was not analyzed. Food insecurity appears only in a reference title; the paper does not substantively address that example. (LLM, conf=0.86)

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2 of the 34 references couldn’t be matched to a known paper.

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  1. Braveman P, Dekker M, Egerter S, Sadegh-Nobari T, Pollack C. Housing and health. Robert Wood Johnson Foundation. 2011. Available from: https:// doi: 10.3122/jabfm.2019.06.190138 Socioeconomics and the Hospitalization of Veterans 901 on 19 July 2023 by guest. Protected by copyright. http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2019.06.190138 on 8 November 2019. Downloaded from www.rwjf.org/en/library/research/2011/05/housing- and-health.html. Accessed April 8, 2019. · DOI
  2. Xu S, Fortney JC, Dong F. Community-level corre- lates of hospitalizations for persons with schizophre- nia. Psychiatr Serv 2009;60:772-778.

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Metadata

Authors
Hatef, E., Kharrazi, H., Nelson, K., Sylling, P., Ma, X., Lasser, E. C., Searle, K. M., Predmore, Z., Batten, A. J., Curtis, I., Fihn, S., & Weiner, J. P.
Affiliations
Johns Hopkins University (US)
ORCID
Venue
The Journal of the American Board of Family Medicine
Publisher
American Board of Family Medicine (ABFM)
Published
2019-11
Volume
32
Issue
6
Pages
890-903
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
DOI
10.3122/jabfm.2019.06.190138
OpenAlex
W2983321750
Cited by
30
References
34
Citations by year
2026: 2 · 2025: 5 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 9 · 2019: 2
FWCI
4.64
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • Johns Hopkins University
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Sociology and Political Science › Urban, Neighborhood, and Segregation Studies
  • Social Sciences › Health › Public Health and Social Inequalities
Keywords
neighborhood socioeconomic status, housing characteristics, hospitalization, veterans, social determinants of health, housing instability, residential heating, primary care medical home, Veterans Health Administration, health care utilization, King County, Washington
MeSH terms
Adult, Aged, Female, Geography, Hospitalization, Hospitals, Veterans, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Residence Characteristics, Socioeconomic Factors, United States, United States Department of Veterans Affairs, Veterans, Electronic Health Records, Veterans Health, Social Determinants of Health

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