Résumé :
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[BDSP. Notice produite par INIST-CNRS 7lG7mR0x. Diffusion soumise à autorisation]. Objectives. We analyzed how ease of geographic access to emergency departments (EDs), defined as driving time to the closest ED, changed between 2001 and 2005, and whether access deterioration was more likely to occur in vulnerable communities. Methods. We classified communities on the basis of American Hospital Association and Census data into 3 categories according to driving time to the nearest ED : no increase, less than a 10-minute increase, and a 10-minute or more increase. We estimated a multinomial logit model to examine the relative risk ratio (RRR) of various community characteristics. Results. More than 95% of communities experienced no ED access deterioration. However, 11.4 million people experienced increased driving time to their nearest ED. Low-income communities had a higher risk of facing deteriorating access compared with high-income communities (urban : RRR=3.67 ; P<. rural : rrr="1.75" p and communities with higher shares of hispanics also had risks facing declines conclusions. deteriorating access to eds is more likely occur in economic hardship high hispanic populations. the uneven critical services warrants increased attention from policy-making bodies.>
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