Preventable illness and out-of-area travel of children in New York counties

Abstract

The long‐distance travellers could be important to any cost–benefit assessment of policies to increase or improve local resources. This study examines the out‐of‐area hospital admission pattern for patients with Ambulatory Care Sensitive (ACS) conditions, also known as preventable conditions. The availability of local resources play a significant role for hospitalization for these conditions. Despite a growing literature investigating hospital choice, little is known about the effects of resource availabilities in local areas and patient characteristics prompting people to seek care at a longer distance from home for these conditions. Based on hospital discharge data for New York residents (children) admitted to hospitals in New York, Pennsylvania, New Jersey or Connecticut in 1994, the study uses logistic regression to predict travel out of the local area for ACS admission. The actual distance between residence and hospital is a highly skewed and problematic measure, but the crossing of county boundaries is a related and very useful dichotomous measure of distant hospitalization. The study finds a strong association of types of insurance and availability of primary care with episodes of hospitalization for children outside the area of residence, after controlling for severity of illness and several other patient and county characteristics. Copyright © 2001 John Wiley & Sons, Ltd.

Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

“…In the adult population, the key factors include male sex, older age, rural residence, degree of remoteness, and socio-economic disadvantage. Higher rates of ACSCs admissions in rural areas have been observed in other studies [9,17,20,26,27,36,38,39]. In Victoria, significant differentials between rural and metropolitan areas have been previously described [43].…”

Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

“…In the adult population, the key factors include male sex, older age, rural residence, degree of remoteness, and socio-economic disadvantage. Higher rates of ACSCs admissions in rural areas have been observed in other studies [9,17,20,26,27,36,38,39]. In Victoria, significant differentials between rural and metropolitan areas have been previously described [43].…”

Educating for rural nursing practice

“…2002) and small rural hospitals struggle to maintain adequate services (Duckett & Kenny 2000). Similar issues that threaten the sustainability of rural hospitals, such as workforce shortages, financial difficulties, increased need for capital, competition for market share and the impact of the shift from inpatient to outpatient care on hospital function, have been identified internationally (Moscovice & Rosenblatt 2000, Ricketts 2000, Trinh & O'Connor 2000, Basu & Friedman 2001).…”

A re‐examination of distance as a proxy for severity of illness and the implications for differences in utilization by race/ethnicity

“…Because of the strong association, distance has been used as a proxy indicator of patient severity (Welch et al, 1993). Several previous studies also reported racial/ethnic differences in travel behavior (Dranove et al, 1993;Basu and Cooper, 2000;Basu and Friedman, 2001;Basu, 2005) and found that members of minority races are less likely to travel further than the rest of the population. To date, none but one study (Basu, 2005) has investigated the role of illness severity in travel patterns across demographic subgroups of the elderly.…”

Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

“…In the adult population, the key factors include male sex, older age, rural residence, degree of remoteness, and socio-economic disadvantage. Higher rates of ACSCs admissions in rural areas have been observed in other studies [9,17,20,26,27,36,38,39]. In Victoria, significant differentials between rural and metropolitan areas have been previously described [43].…”

Educating for rural nursing practice

“…2002) and small rural hospitals struggle to maintain adequate services (Duckett & Kenny 2000). Similar issues that threaten the sustainability of rural hospitals, such as workforce shortages, financial difficulties, increased need for capital, competition for market share and the impact of the shift from inpatient to outpatient care on hospital function, have been identified internationally (Moscovice & Rosenblatt 2000, Ricketts 2000, Trinh & O'Connor 2000, Basu & Friedman 2001).…”

A re‐examination of distance as a proxy for severity of illness and the implications for differences in utilization by race/ethnicity

“…Because of the strong association, distance has been used as a proxy indicator of patient severity (Welch et al, 1993). Several previous studies also reported racial/ethnic differences in travel behavior (Dranove et al, 1993;Basu and Cooper, 2000;Basu and Friedman, 2001;Basu, 2005) and found that members of minority races are less likely to travel further than the rest of the population. To date, none but one study (Basu, 2005) has investigated the role of illness severity in travel patterns across demographic subgroups of the elderly.…”

Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

“…In the adult population, the key factors include male sex, older age, rural residence, degree of remoteness, and socio-economic disadvantage. Higher rates of ACSCs admissions in rural areas have been observed in other studies [9,17,20,26,27,36,38,39]. In Victoria, significant differentials between rural and metropolitan areas have been previously described [43].…”

Educating for rural nursing practice

“…2002) and small rural hospitals struggle to maintain adequate services (Duckett & Kenny 2000). Similar issues that threaten the sustainability of rural hospitals, such as workforce shortages, financial difficulties, increased need for capital, competition for market share and the impact of the shift from inpatient to outpatient care on hospital function, have been identified internationally (Moscovice & Rosenblatt 2000, Ricketts 2000, Trinh & O'Connor 2000, Basu & Friedman 2001).…”

A re‐examination of distance as a proxy for severity of illness and the implications for differences in utilization by race/ethnicity

“…Because of the strong association, distance has been used as a proxy indicator of patient severity (Welch et al, 1993). Several previous studies also reported racial/ethnic differences in travel behavior (Dranove et al, 1993;Basu and Cooper, 2000;Basu and Friedman, 2001;Basu, 2005) and found that members of minority races are less likely to travel further than the rest of the population. To date, none but one study (Basu, 2005) has investigated the role of illness severity in travel patterns across demographic subgroups of the elderly.…”