The federal designation of medically underserved areas (MUA) is attributed to census tracts based on four criteria including: primary care physician-to-population ratio, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population aged 65 and older. This designation is used by federal agencies to determine service need among US communities; yet it is rarely used in research studies. Objective. We hypothesize that fewer children who live inside compared to outside locations designated as federally medically underserved areas (MUA): will be age-appropriately immunized; and will use the emergency room more than primary care services. This cross-sectional study was conducted at a city-situated hospital’s ambulatory care department where it enrolled a random sample of 210 families whose children were insured on Medicaid. A 30 minute interview containing several standardized scales was administered to the caregiver. In addition, permission to abstract children’s medical records was obtained. Findings indicate that caregivers of children living in MUAs compared to those who do not were more likely to: self-identify as minority; use public transportation rather than cars; live in homeless shelters, transitional housing or group homes; receive monthly incomes below $1000; and not have a regular physician. No differences were found in immunization status; however, more children living in MUAs had been treated in emergency rooms compared to those who do not. In efforts to link research to practice, more investigators may want to test criteria used to administer federal funds for services.
Learning Objectives: List four criteria that comprise the federally designated Medically Underserved Areas (MUA). Describe at least three variables associated with low-income families living in MUAs. Identify variables associated with using non-emergent emergency room care for children living with low-income families.
Keywords: Access and Services, Homelessness
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.