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Bypassing the local rural hospital for outpatient procedures.
- Source :
-
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2009 Spring; Vol. 25 (2), pp. 174-81. - Publication Year :
- 2009
-
Abstract
- Purpose: To assess the amount of local rural hospital outpatient department (HOPD) bypass for outpatient procedures.<br />Methods: We analyzed data on colonoscopies and upper gastrointestinal endoscopies performed in the state of Florida over the period 1997-2004.<br />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.<br />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.
- Subjects :
- Colonoscopy statistics & numerical data
Endoscopy, Gastrointestinal statistics & numerical data
Female
Florida
Humans
Insurance, Health statistics & numerical data
Male
Middle Aged
Odds Ratio
Regression Analysis
Ambulatory Care statistics & numerical data
Hospitals, Rural statistics & numerical data
Rural Population statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1748-0361
- Volume :
- 25
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
- Publication Type :
- Academic Journal
- Accession number :
- 19785583
- Full Text :
- https://doi.org/10.1111/j.1748-0361.2009.00214.x