Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Analytical Cohort
2.2. Measuring Continuity of Care
2.3. Measures of Community Characteristics
2.4. Statistical Analyses
3. Results
4. Discussion
4.1. Continuity of Care in Adults Aging with CP/SB
4.2. Community Resources and Care Continuity
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Overall | High COC | Low COC | |
---|---|---|---|
N | 8596 | 4221 | 4375 |
Continuity of Care, mean (SD) | 0.3 (0.19) | 0.52 (0.24) | 0.14 (0.06) |
Individual Characteristics | |||
Age (years), mean (SD) | 48.6 (13.6) | 49.9 (14.2) | 47.3 (13.9) |
Sex, % | |||
Female | 61.6 | 59.1 | 64.0 |
Male | 38.4 | 41.0 | 36.0 |
Comorbidity, mean (SD) | 2.7 (2.0) | 2.6 (2.1) | 2.7 (2.0) |
Community Characteristics (%) | |||
Density of Healthcare Resources | |||
Hospitals | |||
Low | 33.9 | 32.8 | |
Medium | 32.2 | 34.5 | |
High | 34.0 | 32.7 | |
Residential Care/Skilled Nursing Facilities | |||
Low | 33.0 | 33.7 | |
Medium | 32.3 | 34.3 | |
High | 34.7 | 32.0 | |
Ambulatory Care Services | |||
Low | 33.8 | 32.8 | |
Medium | 33.4 | 33.4 | |
High | 32.9 | 33.8 | |
Spatial Accessibility of Healthcare Providers | |||
Family Medicine/Nurse Practitioners | |||
Low | 42.0 | 36.6 | |
Medium | 21.1 | 22.4 | |
High | 37.0 | 40.9 | |
Medical Specialists | |||
Low | 34.6 | 32.1 | |
Medium | 33.8 | 33.0 | |
High | 31.6 | 35.0 | |
Chiropractors | |||
Low | 35.8 | 30.9 | |
Medium | 32.8 | 34.0 | |
High | 31.5 | 35.1 | |
Socioeconomic Structure | |||
Affluence | |||
Low | 37.4 | 29.4 | |
Medium | 33.9 | 32.8 | |
High | 28.7 | 37.8 | |
Disadvantage | |||
Low | 29.6 | 36.9 | |
Medium | 34.8 | 32.0 | |
High | 35.6 | 31.1 | |
Public Infrastructure | |||
Density of Public Transit stops | |||
Low | 45.9 | 45.6 | |
Medium | 20.5 | 21.4 | |
High | 33.6 | 33.0 | |
Density of Broadband Internet Connections | |||
Low | 37.1 | 29.7 | |
Medium | 33.0 | 33.7 | |
High | 30.0 | 36.6 |
Density of Community Characteristics (Ref = High) | Odds Ratio | 95% Confidence Interval |
---|---|---|
Ambulatory Care | ||
Low | 1.10 | (0.87, 1.38) |
Medium | 1.11 | (0.95, 1.31) |
Hospitals | ||
Low | 0.89 | (0.74, 1.07) |
Medium | 0.84 | (0.72, 0.98) |
Residential Care/Skilled Nursing | ||
Low | 0.72 | (0.59, 0.88) |
Medium | 0.84 | (0.73, 0.96) |
Family Medicine/Nurse Practitioners | ||
Low | 1.26 | (1.09, 1.46) |
Medium | 1.05 | (0.92, 1.21) |
Medical Specialists | ||
Low | 1.07 | (0.91, 1.27) |
Medium | 1.10 | (0.96, 1.25) |
Chiropractors | ||
Low | 1.08 | (0.95, 1.23) |
Medium | 1.00 | (0.89, 1.12) |
Public Transit Stops | ||
Low | 1.09 | (0.96, 1.25) |
Medium | 1.15 | (0.99, 1.34) |
Broadband Internet | ||
Low | 1.11 | (0.94, 1.31) |
Medium | 0.99 | (0.87, 1.13) |
Socioeconomic Disadvantage | ||
Low | 0.96 | (0.82, 1.13) |
Medium | 1.15 | (0.99, 1.34) |
Socioeconomic Affluence | ||
Low | 1.55 | (1.29, 1.86) |
Medium | 1.26 | (1.10, 1.45) |
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Khan, A.M.; Lin, P.; Kamdar, N.; Mahmoudi, E.; Clarke, P. Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context. Disabilities 2023, 3, 295-306. https://doi.org/10.3390/disabilities3020019
Khan AM, Lin P, Kamdar N, Mahmoudi E, Clarke P. Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context. Disabilities. 2023; 3(2):295-306. https://doi.org/10.3390/disabilities3020019
Chicago/Turabian StyleKhan, Anam M., Paul Lin, Neil Kamdar, Elham Mahmoudi, and Philippa Clarke. 2023. "Continuity of Care in Adults Aging with Cerebral Palsy and Spina Bifida: The Importance of Community Healthcare and Socioeconomic Context" Disabilities 3, no. 2: 295-306. https://doi.org/10.3390/disabilities3020019