Geographic accessibility and risk of hospitalization and mortality among patients with chronic respiratory diseases

Ghaderi, Gelareh (2019) Geographic accessibility and risk of hospitalization and mortality among patients with chronic respiratory diseases. Masters thesis, Memorial University of Newfoundland.

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Spatial differences exist in hospitalization and mortality among patients with Chronic Obstructive Pulmonary Disease (COPD) and asthma. Objective: Examine the association between geographic accessibility, hospitalization, and mortality among COPD and asthma patients in Newfoundland and Labrador (NL). Methods: A retrospective cohort of adults diagnosed with COPD and asthma were followed from diagnosis until hospitalization, death or end of the study. Geographic accessibility was defined using accessibility-remoteness index. Multivariate and geospatial analyses were performed. Result: We identified 44876 (43.8% inaccessible) COPD patients and 28316 asthma patients (37.4% inaccessible). Living in inaccessible areas increased hospitalization incidence for COPD (OR=2.57, 95% CI 1.54-4.25, P<0.00136) and asthma (OR=12.38, 95% CI:6.28-24.46, P<0.001). Mortality was associated with geographic accessibility only for COPD (OR=10.73, 95% CI; 2.27-44.77, P=0.002). COPD hospitalization (MI=0.034, p<0.03), mortality (MI=0.047, p<0.011) and asthma hospitalization (MI=0.065, p<0.001) were spatially autocorrelated. Conclusion: Living with chronic respiratory diseases in NL remote areas increases risk of hospitalization.

Item Type: Thesis (Masters)
Item ID: 14269
Additional Information: Includes bibliographical references.
Keywords: Geographic Accessibility, Hospitalization, Mortality, COPD, Asthma
Department(s): Medicine, Faculty of
Date: October 2019
Date Type: Submission
Medical Subject Heading: Health Services Accessibility; Pulmonary Disease, Chronic Obstructive; Asthma; Newfoundland and Labrador.

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