Bypassing the Local Rural Hospital for Outpatient Procedures

Autor/inn/en	Saunders, Charles; Bellamy, Gail R.; Menachemi, Nir; Chukmaitov, Askar S.; Brooks, Robert G.
Titel	Bypassing the Local Rural Hospital for Outpatient Procedures
Quelle	In: Journal of Rural Health, 25 (2009) 2, S.174-181 (8 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2009.00214.x
Schlagwörter	Hospitals; Patients; Rural Areas; Risk; Racial Differences; Health Insurance; Physical Health; Diagnostic Tests; Medical Research; Medical Services; Florida + Suchen Sie Ihr Suchwort? Krankengymnast; Krankenhaus; Patient; Rural area; Ländlicher Raum; Risiko; Rassenunterschied; Krankenversicherung; Gesundheitszustand; Diagnostic test; Diagnostischer Test; Arzt
Abstract	Purpose: To assess the amount of local rural hospital outpatient department (HOPD) bypass for outpatient procedures. Methods: We analyzed data on colonoscopies and upper gastrointestinal endoscopies performed in the state of Florida over the period 1997-2004. Findings: Approximately, 53% of colonoscopy and 45% of upper gastrointestinal endoscopy patients bypassed their local rural hospital for treatment at either a free-standing ambulatory surgical center (ASC) or a nonlocal hospital outpatient department. Independent predictors of bypass included risk-adjusted severity of the patient's medical condition, insurance status, and race. Patients treated in ASCs were predominately healthier, white and commercially insured. Nonlocal HOPDs tend to treat a sicker cohort of patients who were publicly insured or under managed care. Conclusions: The results indicate that patients who bypass their local HOPD to an ASC differ from those bypassing to a nonlocal HOPD, and that patient factors influencing bypass for outpatient procedures differ from those influencing inpatient bypass. From a policy perspective, as procedures continue to migrate from the inpatient to the outpatient setting, bypassing the local rural hospital for treatment elsewhere could create conditions that negatively impact rural hospital operations. (As Provided).
Anmerkungen	Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA/
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10