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应用相似性指数于国家出院摘要数据,以识别外科手术和麻醉业务增长的机会。

Application of a similarity index to state discharge abstract data to identify opportunities for growth of surgical and anesthesia practices.

作者信息

Wachtel Ruth E, Dexter Elisabeth U, Dexter Franklin

机构信息

Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa 52242, USA.

出版信息

Anesth Analg. 2007 May;104(5):1157-70, tables of contents. doi: 10.1213/01.ane.0000260335.08877.3e.

Abstract

INTRODUCTION

Most surgical and anesthesia groups are interested in expanding their practices and recruiting more patients. Methods have been developed to help hospitals identify surgical specialties with the potential for growth by determining whether the hospital is performing fewer of certain types of procedures than expected in a given specialty. However, these methods are not appropriate for physicians who may practice at more than one hospital and want to determine the potential for growth in their regions.

METHODS

We examined potential markets for growth of surgical and anesthesia practices in Iowa and New York State using state discharge abstract data. Several patient demographic groups and several surgical specialties were examined. Each state was divided into regions, and data were analyzed three ways: (1) A similarity index compared each region to the rest of the state. (2) The number of procedures performed on patients who left their home regions for care was determined. (3) A similarity index compared procedures performed on patients who left their home regions for care with procedures performed on patients who remained within their home regions.

RESULTS

The methods successfully identified several geographic regions with previously unrecognized growth potential. Access to care was limited in these regions. The methods correctly showed few opportunities for growth in geographic regions where expansion was already known to be unlikely.

CONCLUSIONS

A count of the number of procedures performed on patients who left their home regions, in combination with the similarity index, is a useful method for screening state discharge abstract data to identify geographic regions where surgical and anesthesia practices could grow.

摘要

引言

大多数外科和麻醉科室都有兴趣扩大业务并招募更多患者。已经开发出一些方法来帮助医院确定具有增长潜力的外科专科,通过判断医院在特定专科中执行的某些类型手术的数量是否少于预期。然而,这些方法不适用于可能在多家医院执业并希望确定其所在地区增长潜力的医生。

方法

我们使用州出院摘要数据研究了爱荷华州和纽约州外科和麻醉业务的潜在增长市场。研究了几个患者人口统计学群体和几个外科专科。每个州都被划分为多个地区,并通过三种方式分析数据:(1)一个相似性指数将每个地区与该州的其他地区进行比较。(2)确定对离开家乡地区就医的患者进行的手术数量。(3)一个相似性指数将对离开家乡地区就医的患者进行的手术与对留在本地区的患者进行的手术进行比较。

结果

这些方法成功地识别出了几个具有此前未被认识到的增长潜力的地理区域。这些地区的医疗服务可及性有限。对于已知扩张可能性不大的地理区域,这些方法正确地显示出增长机会很少。

结论

统计离开家乡地区就医的患者所接受手术的数量,并结合相似性指数,是筛选州出院摘要数据以识别外科和麻醉业务可能增长的地理区域的一种有用方法。

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