Makuc D, Kleinman J C, Pierre M B
Health Serv Res. 1985 Apr;20(1):1-18.
This article evaluates three alternative definitions of physician service areas using data from the 1978 National Health Interview Survey. The three types of areas are county aggregations based on different data sources: the Bureau of Economic Analysis Economic Areas (BEAAs), Ranally Basic Trading Areas (RBTAs), and Health Care Commuting Areas (HCCAs). The three types of areas differ substantially in size, population, urbanization, and the availability of physicians. The overall percentage of physician visits outside each of the three areas was small, ranging from 3 percent for BEAAs to 5 percent for RBTAs and HCCAs. Visits by nonmetropolitan residents were about four times as likely as those by metropolitan residents to occur outside of each area. The results suggest that HCCAs are the most appropriate primary care physician service areas because they are the smallest in size and population and have the greatest variability in physician supply, yet they exhibit an amount of outside-area travel for care similar to that of the two larger types of areas.
本文利用1978年国民健康访谈调查的数据，评估了医生服务区域的三种替代定义。这三种区域类型是基于不同数据源的县集合：经济分析局经济区（BEAAs）、拉纳利基本贸易区（RBTAs）和医疗保健通勤区（HCCAs）。这三种区域类型在规模、人口、城市化程度和医生可及性方面存在很大差异。在这三个区域之外进行的医生诊疗的总体百分比很小，从BEAAs的3%到RBTAs和HCCAs的5%不等。非大都市居民的诊疗发生在每个区域之外的可能性大约是大都市居民的四倍。结果表明，HCCAs是最合适的初级保健医生服务区域，因为它们在规模和人口上最小，医生供应的差异最大，但它们的区域外就医出行量与另外两种较大区域类型的相似。
