Background: We used GIS to understand the spatial pattern of preventable hospitalizations due to diabetic complications in Bronx County, New York City during 1991-1994 period. Upon identification of diabetes complications “hot zones,” we visually characterized the affected communities in order to devise culturally sensitive intervention plan and to understand the availability of primary care resources.
Methods: Based on the notion of Ambulatory Care Sensitive (ACS) conditions, the cases were identified from the statewide hospital discharge data released by New York Statewide Planning and Research Cooperative System (SPARCS). Trends in hospitalization from diabetic complications among the Bronx population were created with the mapping software, MapInfo. MapInfo further aided us in identifying existing community organizations – which we hope to use as a bridge to build partnerships with neighborhood organizations – in the target neighborhoods.
Results: A thematic map of preliminary assessment demonstrates that the hospitalization rate due to preventable complications of diabetes in the southwestern portion of the Bronx (49 hospitalizations/1000 persons/year) was about 10-times higher than the rate for New York City as a whole (5 hospitalizations /1000 persons/year). Diabetic “hot zones,” zip codes 10454, 10455 and 10456, in the Bronx are mostly inhabited by racial and ethnic minorities. Over 60 % of the residents in these areas are below the national poverty line. Moreover, the area suffers from a severe shortage of health professionals (one primary care clinic / 468,058 people living within 1.5-mile radius of the clinic).
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Learn how GIS can be tailored to meet specific objectives of COPC project. 2. Articulate steps necessary to evaluate community-based control trial to reduce the rate of diabetes complication occurrence. 3. Apply the GIS evaluation method to track change in hospitalization rate of ambulatory care-sensitive conditions in community-based chronic disease intervention project.
Keywords: Community-Oriented Primary Care, Geographic Information Systems
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