Jia Peng, Xierali Imam M
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214. Telephone: 716-829-5354. Email:
Louisiana State University, Baton Rouge, Louisiana, and Association of American Medical Colleges, Washington, DC.
Prev Chronic Dis. 2015 Sep 17;12:E150. doi: 10.5888/pcd12.150079.
Congestive heart failure (CHF) is a major public health problem in the United States and is a leading cause of hospitalization in the elderly population. Understanding the health care travel patterns of CHF patients and their underlying cause is important to balance the supply and demand for local hospital resources. This article explores the nonclinical factors that prompt CHF patients to seek distant instead of local hospitalization.
Local hospitalization was defined as inpatients staying within hospital service areas, and distant hospitalization was defined as inpatients traveling outside hospital service areas, based on individual hospital discharge data in 2011 generated by a Dartmouth-Swiss hybrid approach. Multiple logistic and linear regression models were used to compare the travel patterns of different groups of inpatients in Florida.
Black patients, no-charge patients, patients living in large metropolitan areas, and patients with a low socioeconomic status were more likely to seek local hospitalization than were white patients, those who were privately insured, those who lived in rural areas, and those with a high socioeconomic status, respectively.
Findings indicate that different populations diagnosed with CHF had different travel patterns for hospitalization. Changes or disruptions in local hospital supply could differentially affect different groups in a population. Policy makers could target efforts to CHF patients who are less likely to travel to seek treatment.
充血性心力衰竭(CHF)是美国一个主要的公共卫生问题,也是老年人群住院治疗的主要原因。了解CHF患者的就医出行模式及其潜在原因对于平衡当地医院资源的供需至关重要。本文探讨了促使CHF患者寻求异地而非本地住院治疗的非临床因素。
根据达特茅斯-瑞士混合方法生成的2011年各医院出院数据,将本地住院定义为住院患者在医院服务区域内住院,异地住院定义为住院患者前往医院服务区域外住院。使用多个逻辑回归和线性回归模型比较佛罗里达州不同住院患者群体的出行模式。
黑人患者、免费患者、居住在大城市地区的患者以及社会经济地位较低的患者分别比白人患者、有私人保险的患者、居住在农村地区的患者以及社会经济地位较高的患者更有可能寻求本地住院治疗。
研究结果表明,不同的CHF确诊人群有不同的住院出行模式。当地医院供应的变化或中断可能会对人群中的不同群体产生不同影响。政策制定者可以将工作重点放在不太可能前往外地寻求治疗的CHF患者身上。