Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

4
HOSPITAL PATIENT TRAVEL PATTERNS IN SOUTH FLORIDA

Do the differences in which people and services are funded in turn make a difference in patient utilization patterns?

In this section, we present the findings of our analyses of geographic access to care as measured through patient travel patterns within and among the three South Florida counties. Two different analyses are discussed. The first is a patient level analysis to determine where the patient was admitted in relationship to his or her residence. The second uses the same information but examines the patient population by hospital. Both analyses provide information about geographic access to hospital care services. Both analyses use the patient-level hospital discharge data for 2000 from Florida State's Agency for Health Care Administration (AHCA). All Florida hospitals are required to report this information annually.


PATIENT-LEVEL TRAVEL PATTERNS

Good geographic access is defined through convenient access to care. When care is difficult to obtain because it is geographically distant, poor geographic access results. Conventional wisdom states that patients go to hospitals that are close to their homes, and this behavior is common among persons living in the same area regardless of insurance status.57 The extent to which the travel patterns vary among persons living in the same area can tell us something about barriers to care. In this section, we present a brief narrative discussion of the analytic methodology; a more complete discussion is included as Appendix B.


Analytic Methodology

To measure travel patterns, we employ a proximity metric that measures the relative straight-line distance from the center of the patient's residential zip code to the center of the zip code of the hospital where admitted. Specifically, this metric counts the number of hospitals that the patient skipped before admission. Because there are areas of high hospital

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57
We later show that this conventional wisdom holds in south Florida.

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