2.50
Hdl Handle:
http://hdl.handle.net/10755/157876
Type:
Presentation
Title:
The Relationship Between Distance Travelled and Health Outcomes
Abstract:
The Relationship Between Distance Travelled and Health Outcomes
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Sweeney Fee, Sharon, RN, PhD
P.I. Institution Name:Montana State University-Bozeman
Title:Assistant Professor
Contact Address:College of Nursing, 214 Sherrick Hall, Box 173560, Bozeman, MT, 59717-3560, USA
Contact Telephone:406-994-2705
Purpose: This exploratory study utilized Donabedian's Quality Model to study patients who traveled for health care. One year of the Arizona Department of Health Services Discharge Database was used to analyze patient characteristics that influenced travel and understand the impact of distance on risk adjusted patient outcomes. Background: Rural patients frequently travel long distances to obtain care in urban settings (Basu & Cooper, 2000). As a result, their health experience may be very different from their urban counterparts. Recent studies of patient travel, or migration, have investigated the characteristics of patients who travel and the type of systems to which they travel (Basu and Cooper, 2000; Nemet & Bailey, 2000). Little is known about the role of distance on health outcomes. Methods: Geographic Interface software and zip code analysis were used to measure the distance between patient zip codes and the treating hospital. Frequency analysis and analysis of variance were used to identify characteristics of patients who traveled over varied distances for care. Risk adjustment and regression analysis were used to evaluate the relationship between distance and the health outcomes of length of stay and number of procedures performed. Results: Miles traveled ranged from 31 to over 800 miles with seventy five percent of the cases traveling 200 miles or less. The key findings for patients who traveled greater distances included care at larger hospitals, were an emergency admission, had private insurance, and received critical care services with a Neuro/Ortho/Trauma primary diagnosis. Patients who traveled shorter distances were cared for at smaller hospitals as a referral or transfer, had Medicaid insurance and Women's Health primary diagnosis. Regression analysis demonstrated that patients who traveled farther received fewer procedures and had a longer length of stay. A preliminary cost analysis of the length of stay outliers identified approximately four million dollars in potentially non-reimbursable charges. Implications: The results clearly demonstrate the need for health policy institutions to begin to use different models to analyze the needs and outcomes of rural patients and the systems that care for them. The technology exists to allow for the development of improved frameworks for understanding rural patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Relationship Between Distance Travelled and Health Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157876-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Relationship Between Distance Travelled and Health Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Sweeney Fee, Sharon, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montana State University-Bozeman</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, 214 Sherrick Hall, Box 173560, Bozeman, MT, 59717-3560, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">406-994-2705</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sfee@montana.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: This exploratory study utilized Donabedian's Quality Model to study patients who traveled for health care. One year of the Arizona Department of Health Services Discharge Database was used to analyze patient characteristics that influenced travel and understand the impact of distance on risk adjusted patient outcomes. Background: Rural patients frequently travel long distances to obtain care in urban settings (Basu &amp; Cooper, 2000). As a result, their health experience may be very different from their urban counterparts. Recent studies of patient travel, or migration, have investigated the characteristics of patients who travel and the type of systems to which they travel (Basu and Cooper, 2000; Nemet &amp; Bailey, 2000). Little is known about the role of distance on health outcomes. Methods: Geographic Interface software and zip code analysis were used to measure the distance between patient zip codes and the treating hospital. Frequency analysis and analysis of variance were used to identify characteristics of patients who traveled over varied distances for care. Risk adjustment and regression analysis were used to evaluate the relationship between distance and the health outcomes of length of stay and number of procedures performed. Results: Miles traveled ranged from 31 to over 800 miles with seventy five percent of the cases traveling 200 miles or less. The key findings for patients who traveled greater distances included care at larger hospitals, were an emergency admission, had private insurance, and received critical care services with a Neuro/Ortho/Trauma primary diagnosis. Patients who traveled shorter distances were cared for at smaller hospitals as a referral or transfer, had Medicaid insurance and Women's Health primary diagnosis. Regression analysis demonstrated that patients who traveled farther received fewer procedures and had a longer length of stay. A preliminary cost analysis of the length of stay outliers identified approximately four million dollars in potentially non-reimbursable charges. Implications: The results clearly demonstrate the need for health policy institutions to begin to use different models to analyze the needs and outcomes of rural patients and the systems that care for them. The technology exists to allow for the development of improved frameworks for understanding rural patients.</td></tr></table>en_GB
dc.date.available2011-10-26T20:17:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:17:24Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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