Kleinman J C, Makuc D
Med Care. 1983 May;21(5):543-57. doi: 10.1097/00005650-198305000-00007.
This article describes travel patterns for ambulatory care based on the 1978 National Health Interview Survey. The county where a physician visit occurs has been compared with the county of patient's residence. Nearly 20 per cent of physician visits occur outside the county of residence, with substantial variation according to metropolitan status and proximity to an SMSA. Visits by nonmetropolitan residents are twice as likely to occur in another county as visits by metropolitan residents. The proportion of visits that occur outside the county of residence increases with decreasing population density, both among metropolitan and nonmetropolitan areas. Travel patterns for the usual source of care are similar to those for primary care physician visits. The results are used to estimate adjusted physician-population ratios by allocating physicians to each county type in proportion to their use by residents. These adjusted ratios exhibit substantially less variation than the unadjusted ratios.
本文基于1978年全国健康访谈调查描述了门诊医疗的就诊模式。将患者看诊所在的县与患者居住的县进行了比较。近20%的看诊发生在居住县以外，根据大都市地位和与标准都市统计区的距离存在很大差异。非大都市居民在另一个县看诊的可能性是大都市居民的两倍。居住县以外的看诊比例随着人口密度的降低而增加，无论是在大都市地区还是非大都市地区。常规医疗服务来源的就诊模式与初级保健医生看诊的模式相似。通过按居民使用比例将医生分配到每种县类型来估计调整后的医生与人口比例。这些调整后的比例与未调整的比例相比，差异显著减小。
