Quantifying Effect of a Hospital’s Caseload for a Surgical Specialty on That of Another Hospital Using Multi-Attribute Market Segments

Abstract

Inpatient and outpatient data were used to create market segments consisting of hierarchical combinations of surgical procedure, then type of payer, and then location of patients' residences. The competitive effect of one hospital's caseload for a given surgical specialty on the caseload of another hospital was determined from the numbers of patients in each segment. Earlier methods for estimating surgical competition that ignored market segments over-estimated the competitive effects of one hospital on another. Thus, results differed from those obtained previously for all types of hospital admissions. When actual market segments with homogeneous groups of patients are used, competitive effects of hospitals in the same market area are far less than expected.

Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program

“…Our focus on the referring physician in the context of the treatment of a brain tumor seems appropriate based on the study of Charlton et al, who demonstrated that most rectal cancer patients relied on the advice of their own physician, and few attempted to assess either surgeon volume or experience in deciding where to seek definitive treatment [ 18 ]. Our finding that a substantive number of patients (e.g., from Miami-Dade, Palm Beach, and Broward counties) drove past many other hospitals offering brain surgery or traveled to Miami (e.g., from Collier and Lee counties) rather than to closer hospitals in the opposite direction is consistent with the study of Dexter et al, who showed that absolute distance rather than relative distance was the important travel consideration [ 19 ]. Based on previous survey studies indicating that patients focus more on the reputation of the surgeon than on that of the hospital [ 20 - 22 ], it is likely that the neurosurgeon’s practice growth was more related to his personal marketing efforts (e.g., hospital and medical society speaking engagements, dissemination of his personal cell-phone number) rather than the hospital’s general marketing campaigns.…”

Should Anesthesia Groups Advocate Funding of Clinics and Scheduling Systems to Increase Operating Room Workload?

“…15,[33][34][35] We have developed other techniques applicable to all hospitals, especially those in metropolitan areas. 36 Neither uses information about primary care networks or formal modeling of referral networks. Rather, the principal inputs are market visibility of the hospital and overall regional surgical workload.…”

The Surgical Scheduling Problem: Current Research and Future Opportunities

“…Exploring patient selection from a longer‐term, strategic perspective, Wachtel and Dexter (2004) used a statewide discharge abstract database to quantify physiologically complex operative procedures performed throughout Iowa in patients aged 80 and older during January through June 2001. Dexter et al (2005c) used inpatient and outpatient data to create market segments consisting of hierarchical combinations of surgical procedure, then type of payer, and then location of patients' residences. They determined the competitive effect of one hospital's caseload for a given surgical specialty on the caseload of another hospital from the numbers of patients in each segment.…”