Community correlates of pneumonia hospitalization and mortality among persons 65 years and older in Texas counties

This study contributes knowledge to the overarching goals of Healthy People 2010, as it examined an objective aimed at improving population health of a priority population in the United States. The study aims examined the effect of health care quality on pneumonia among persons 65+ in Texas counties, and considered how community (county) characteristics such as prosperity and racial/ethnic homogeneity impact population health and well-being.\r\n The project applied Evans and Stoddart determinants of health model to examine the effect and relationship of contextual factors on two AHRQ quality of health care indicators, and their influence on population health. The project utilized 1999-2001 Texas hospital discharge data to estimate county bacterial pneumonia hospitalization rates and pneumonia inpatient mortality rates. Population counts and contextual factors were derived from Census 2000 Summary Files. Population mortality rates were estimated from 1999-2001 Texas vital statistics files.\r\n Study results showed an association between increasing percent Latinos in a county and lower bacterial pneumonia hospitalization rates, not just for Latinos, but also for non-Hispanic Blacks and non-Hispanic Whites. Results indicate bacterial pneumonia hospitalization rates increase significantly with age, especially in persons 75+, with males experiencing higher rates than females. Persons with high risk of mortality scores experienced significantly higher mortality rates in the hospital setting. Community pneumonia mortality rates were similar to those for bacterial pneumonia hospitalizations, and bacterial pneumonia hospitalizations were associated with community pneumonia mortality.\r\n In summary, this research provides baseline pneumonia morbidity and mortality data for Texas counties by which to evaluate future health studies among the elderly. The methodology demonstrates the application of hospital discharge data in community based health services research and contributes to understanding neighborhood influences on population health. It may contribute to policy considerations for Texas counties by allowing stakeholders to assess population health status for funding and treatment priorities. \r\n Finally, this research represents a stepping stone to research that can guide future community-based interventions to improve care, and provides a model for other states to evaluate community correlates of mortality and morbidity. The model could potentially be applied to many different conditions affecting community health, such as immunizations.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Grantor

The University of Texas Medical Branch

Year dc:date.issued

2007

Author dc:creator

• Frank Christopher Lemus

Advisor dc:contributor.advisor

• Jean L. Freeman, PhD

Committee members dc:contributor.committeemember

• Michael A. Stoto
• Karl Eschbach, PhD
• James S. Goodwin, MD
• Elizabeth T. Anderson, DrPH, RN
• Daniel H. Freeman, Jr., PhD
• C. Glen Mayhall, MD

• Texas
• residence characteristics
• quality indicators
• Pneumonia
• health services research
• health care
• bacterial
• aged

Statement dc:rights

• Copyright © is held by the author. Presentation of this material on the TDL web site by The University of Texas Medical Branch at Galveston was made possible under a limited license grant from the author who has retained all copyrights in the works.

Language dc:language.iso

eng

Dc Identifier Other

etd-08072007-111537

OAI identifier oai:identifier

oai:utmb-ir.tdl.org:2152.3/204