Residential Segregation and the Survival of U.S. Urban Public Hospitals. (June 2014)

• Record Type: Journal Article
• Authors: Ko, Michelle; Needleman, Jack; Derose, Kathryn Pitkin; Laugesen, Miriam J.; Ponce, Ninez A.
• Is Part Of: Medical care research and review. Volume 71:Number 3(2014:Jun.)
• Page Start: 243
• Page End: 260
• Publication Date: 2014-06
• Subjects: public hospitals -- hospital closures and conversions -- safety net -- residential segregation; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/1077558713515079
• Languages: English
• ISSNs: 1077-5587

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.