Association Between Insurer Connectivity in Appalachian Population Health Networks and Preventable Hospitalizations: Evidence from Kentucky

Authors

Rachel Hogg-Graham, University of Kentucky, College of Public HealthFollow
Kelsey R. Gatton, University of Kentucky, College of Public HealthFollow
Rick Ingram, University of KentuckyFollow
Glen P. Mays, Department of Health Systems, Management and Policy Colorado School of Public HealthFollow

Corresponding Author

Rachel Hogg-Graham

rachel.hogg@uky.edu

Author Affiliations

1. Rachel Hogg-Graham, DrPH, MA

Associate Professor

College of Public Health,

University of Kentucky

Lexington KY

2. Kelsey R. Gatton, BPH, BHS

MPH Candidate

College of Public Health,

University of Kentucky

3. Richard C. Ingram, DPH

Associate Professor

College of Public Health,

University of Kentucky

4. Glen P. Mays, PhD, MPH

Professor and Chair (Department of Health Systems, Management and Policy)

Colorado School of Public Health

CU Anschutz Medical Campus

Aurora CO

Author Area of Expertise

Rachel Hogg-Graham: population health systems, partnerships, social determinants of health

Kelsey R. Gatton: MPH student

Richard C. Ingram: public health systems, public health accreditation

Glen P. Mays: public health system, public health finance

Abstract

Introduction: Addressing complex health and social needs requires cross-sector collaboration to deliver medical, social, and population health services at the community level. Capacity in community health and social services networks may be constrained in regions like Appalachia due to the combined effects of rurality and persistently poor health and social outcomes. One way that cross-sector networks serving low-resource communities can expand their capacity is by engaging partners, like health insurers, who can leverage resources from outside the local area.

Purpose: This study examines insurer connectivity in cross-sector networks across Kentucky’s geographic regions and the association between connectivity and the probability of an individual experiencing a preventable hospitalization.

Methods: A cross-sectional design was used that linked data from the National Longitudinal Survey of Public Health Systems (NALSYS) with 2018 patient-level Kentucky hospital discharge data to examine the association between insurer connectivity in community networks and preventable hospitalizations across urban, rural non-Appalachian, and Appalachian regions.

Results: Analysis of the data shows substantial geographic variation in the association between insurer connectivity in community networks and preventable hospitalization. Insurer connectivity in rural Appalachian communities was associated with lower likelihood that an individual was admitted for a preventable hospitalization (p < 0.01).

Implications: Findings suggest insurer connectivity in cross-sector community health and social services networks has the potential to strengthen network capacity to address preventable hospitalizations and improve health outcomes and well-being for the people of Appalachia.

DOI

https://doi.org/10.13023/jah.0502.03

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Hogg-Graham R, Gatton KR, Ingram R, Mays GP. Association between insurer connectivity in Appalachian population health networks and preventable hospitalizations: Evidence from Kentucky. J Appalach Health 2023;5(2):15–31. DOI: https://doi.org/10.13023/jah.0502.03.