Socioeconomic Disparities for Healthcare Utilization of Senior Adult Falls in Southeast Wisconsin, 2020-2022

Abstract

AbstractBackgroundTo examine the social determinant factors of the healthcare utilizations for senior patients with history of falls.MethodsWe analyzed effects of socioeconomic factors on the utilization rate of healthcare in a tertiary care center including 495,041 senior adults. We included Zip Code Tabulation Areas to measure socioeconomic factors on a community level. Cohort group comparison and multiple linear regression models evaluated the association between healthcare services utilization and age, sex, education, race, insurance type, distance, and income levels.ResultsPatients with a history of falls were older than those without a history of falls (79.4 ± 12.1 vs. 75.4 ± 11.6 years old), predominantly female (odds ratio [OR]: 1.26, 95% confidence interval [95% CI]: 1.24–1.28), white (OR: 1.35, 95% CI: 1.32–1.38). Patients with a fall history were predominantly retired (OR: 2.53, 95% CI: 2.49–2.58), publicly insured (OR: 2.88, 95% CI: 2.82–2.93), and more likely to require an interpreter during a hospital visit (OR: 2.40, 95% CI: 2.35–2.44). Using a geospatial analysis, healthcare utilization was higher in areas close to the care center. A regression model showed that a community’s median income, private insurance rate, and college education rate were positively associated with healthcare utilization.ConclusionsLower utilization of healthcare is associated with disadvantaged neighborhood social conditions, including under-insured status, residing far from a hospital, lower education, and lower income. We revealed the current inequities and disparities in the healthcare of senior adult fall patients in Southeast Wisconsin.Summary1)What is the current understanding of this subject?Current healthcare outcome studies focus on risk factors of falls. However, there is a lack of studies on patient socioeconomic effects to the healthcare utilization.2)What does this report add to the literature?The study reveals the potential socioeconomic inequities and disparities in the healthcare adoption of the senior adult falls.3)What are the implications for public health practice?With the growing percentage of senior adult populations, specific strategies are needed to address the disparities to the adoption in underserved senior populations.