ERIC Number: EJ862452
Record Type: Journal
Publication Date: 2009
Abstractor: As Provided
Reference Count: 30
Bypassing the Local Rural Hospital for Outpatient Procedures
Saunders, Charles; Bellamy, Gail R.; Menachemi, Nir; Chukmaitov, Askar S.; Brooks, Robert G.
Journal of Rural Health, v25 n2 p174-181 Spr 2009
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.
Descriptors: Hospitals, Patients, Rural Areas, Risk, Racial Differences, Health Insurance, Physical Health, Diagnostic Tests, Medical Research, Medical Services
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A
Identifiers - Location: Florida