Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Monsour MJ[original query] |
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Geographic access to obstetric critical care for women of reproductive age by race and ethnicity
Kroelinger CD , Brantley MD , Fuller TR , Okoroh EM , Monsour MJ , Cox S , Barfield WD . Am J Obstet Gynecol 2020 224 (3) 304 e1-304 e11 BACKGROUND: The goal of risk-appropriate maternal care is for high-risk pregnant women to receive specialized obstetric services in facilities equipped with capabilities and staffing to provide care or transfer to facilities with resources available to provide care. In the United States (US), geographic access to obstetric critical care (OCC) varies. It is unknown if this variation in proximity to OCC differs by race, ethnicity, and region. OBJECTIVES: We examined the geographic access, defined as residence within 50 miles of a facility capable of providing risk-appropriate OCC services for women of reproductive age, by distribution of race and ethnicity. STUDY DESIGN: Descriptive spatial analysis was used to assess geographic distance to OCC for women of reproductive age by race and ethnicity. Data were analyzed geographically: nationally, by Department of Health and Human Services (HHS) regions, and by all 50 states and the District of Columbia. Dot density analysis was used to visualize geographic distributions of women by residence and OCC facilities across the US. Proximity analysis defined the proportion of women living within an approximate 50-mile radius of facilities. Source data included 2015 American Community Survey from the US Census Bureau and the 2015 American Hospital Association Annual Survey. RESULTS: Geographic access to OCC was greatest for Asian/Pacific Islander women of reproductive age (95.8%), followed by black (93.5%), Hispanic (91.4%), and white women of reproductive age (89.1%). American Indian/Alaska Native (AI/AN) women had more limited geographic access at 66% in all regions. Visualization of proximity to OCC indicated facilities were predominantly located in urban areas, which may limit access to women in frontier or rural areas of states including nationally recognized reservations where larger proportions of white and AI/AN women reside, respectively. CONCLUSIONS: Disparities in proximity to OCC exist in rural and frontier areas of the US, which impact white and AI/AN women, primarily. Examining insurance coverage, inter-state hospital referral networks, and transportation barriers may provide further insight into OCC accessibility. Further exploring the role of other equity-based measures of access on disparities beyond geography is warranted. |
Decomposition of an autoregressive process into first order processes
Monsour MJ . J Multivar Anal 2016 147 295-314 Let Yn be an autoregressive process of order p. With p distinct characteristic roots, Yn can be decomposed into or expressed as a linear combination of p first order autoregressive processes. For the case of multiple characteristic roots, Yn with s<p distinct characteristic roots can be expressed as a linear combination of s first order autoregressive processes and the derivatives with respect to the parameter of the s first order processes. The parameters of the first order processes are the characteristic roots of Yn. Using this decomposition, for general stationary and unstable characteristic roots, the limiting distribution of appropriately normalized maximum likelihood estimators for the parameters of Yn are obtained. These results are new to the literature. |
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