Study of Ambulatory Care Sensitive Diagnoses as a Monitor of Primary Access, 1993: [California] (ICPSR 6570)

Published: Jan 18, 2006

Principal Investigator(s):
Andrew B. Bindman

Version V1

The purpose of this study was to examine whether higher hospital admission rates for chronic medical conditions result from community differences in access to care, prevalence of the chronic medical conditions, propensity to seek care, or physician admitting style. In multiple California communities, five chronic medical conditions were studied: asthma, chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus, and hypertension. This collection includes data from two surveys, one of adults in the communities (Part 1, Community Health Care Survey Data), and the other of physicians who provide adult primary care in the same communities (Part 3, Physician Practice Survey Data). Topics covered included respondent self-report of access to care in the community (including health insurance status, whether the respondent had a regular source of care, and specific and overall difficulties in obtaining care), respondent propensity to seek care (how important the respondent thought it was to see a physician for each of five major symptoms), physician predisposition to hospitalize patients, and physician responsiveness to patients' social factors (such as whether the patient was an alcoholic or an IV drug user, uninsured, homeless, lived alone, or was covered by Medicaid). Demographic variables include sex, race, education, household income, and marital status.

Bindman, Andrew B. Study of Ambulatory Care Sensitive Diagnoses as a Monitor of Primary Access, 1993: [California]. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2006-01-18.

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Robert Wood Johnson Foundation (18869)

As explained in the ICPSR Processing Note in the codebook, some variables are restricted from general dissemination for reasons of confidentiality. Users interested in obtaining these data must complete an Agreement for the Use of Confidential Data, specify the reasons for the request, and obtain IRB approval or notice of exemption for their research. Apply for access to these data through the ICPSR restricted data contract portal, which can be accessed via the study home page.

1993-04 -- 1993-07

1993-04 -- 1993-07

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Community Health Care Survey: 2,656 California ZIP codes were aggregated into 250 urban and 144 rural ZIP-code clusters. Using random-digit dialing, households were selected from a stratified random sample of 52 of these 394 clusters. Within households, respondents were randomly selected from among eligible adults. Physician Practice Survey: all emergency physicians in selected clusters, and either a total of 30 or 25 percent of the primary care physicians in selected clusters, whichever was larger. Some physicians from outside the selected clusters were also sampled.

Community Health Care Survey: English- and Spanish-speaking adults between the ages of 18 and 64 years living in California for a minimum of three months. Physician Practice Survey: California providers of primary adult care (general internists, family physicians, general practitioners) and emergency physicians listed in the American Medical Association Physician Masterfile.

self-enumerated questionnaires, and telephone interviews

survey data



2006-01-18 File CB6570.ALL.PDF was removed from any previous datasets and flagged as a study-level file, so that it will accompany all downloads.

1998-05-01 The codebook is now available as a PDF file.


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This study is maintained and distributed by the Health and Medical Care Archive (HMCA). HMCA is the official data archive of the Robert Wood Johnson Foundation.