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The distance to community medical care and the likelihood of hospitalization: Is closer always better?

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  • Goodman, D.C.
  • Fisher, E.
  • Slukel, T.A.
  • Chang, C.-H.

Abstract

Objectives: This study examined the influence that distance from residence to the nearest hospital had on the likelihood of hospitalization and mortality. Methods: Hospitalizations were studied for Maine, New Hampshire, and Vermont during 1989 (adults) and for 1985 through 1989 (children) and for mortality (1989) in Medicare enrollees. Results: After other known predictors of hospitalization (age, sex, bed supply, median household income, rural residence, academic medical center, and presence of nursing home patients) were controlled for, the adjusted rate ratio of medical hospitalization for residents living more than 30 minutes away was 0.85 (95% confidence interval [CI] = 0.82, 0.88) for adults and 0.78 (95% CI = 0.74, 0.81) for children, compared with those Flying in a zip code with a hospital. Similar effects were seen for the four most common diagnosis- related groups for both adults and children. The likelihood of hospitalization for conditions usually requiring hospitalization and for mortality in the elderly did not differ by distance. Conclusions: Distance to the hospital exerts an important influence on hospitalization rates that is unlikely to be explained by illness rates.

Suggested Citation

  • Goodman, D.C. & Fisher, E. & Slukel, T.A. & Chang, C.-H., 1997. "The distance to community medical care and the likelihood of hospitalization: Is closer always better?," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1144-1150.
    • Handle: RePEc:aph:ajpbhl:1997:87:7:1144-1150_9
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    2. Marissa B Kosnik & David M Reif & Danelle T Lobdell & Thomas Astell-Burt & Xiaoqi Feng & John D Hader & Jane A Hoppin, 2019. "Associations between access to healthcare, environmental quality, and end-stage renal disease survival time: Proportional-hazards models of over 1,000,000 people over 14 years," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-17, March.
    3. Roll, Kathrin, 2012. "The influence of regional health care structures on delay in diagnosis of rare diseases: The case of Marfan Syndrome," Health Policy, Elsevier, vol. 105(2), pages 119-127.
    4. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    5. Núria Mas, 2013. "Responding to financial pressures. The effect of managed care on hospitals’ provision of charity care," International Journal of Health Economics and Management, Springer, vol. 13(2), pages 95-114, June.
    6. Ting Chen & Jay Pan, 2022. "The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 645-665, April.
    7. Fabbri, D & Robone, S, 2008. "The geography of hospital admission in a National Health Service with patient choice: evidence from Italy," Health, Econometrics and Data Group (HEDG) Working Papers 08/29, HEDG, c/o Department of Economics, University of York.
    8. Nai Yang & Shiyi Chen & Weilu Hu & Zhongheng Wu & Yi Chao, 2016. "Spatial Distribution Balance Analysis of Hospitals in Wuhan," IJERPH, MDPI, vol. 13(10), pages 1-16, September.
    9. Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 334-359, Summer.
    10. Liliana Dumitrache & Mariana Nae & Gabriel Simion & Ana-Maria Taloș, 2020. "Modelling Potential Geographical Access of the Population to Public Hospitals and Quality Health Care in Romania," IJERPH, MDPI, vol. 17(22), pages 1-18, November.
    11. Scott W. Allard & Richard M. Tolman & Daniel Rosen, 2003. "Proximity to service providers and service utilization among welfare recipients: The interaction of place and race," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 22(4), pages 599-613.
    12. Louis-Francois Tétreault & Marieve Doucet & Philippe Gamache & Michel Fournier & Allan Brand & Tom Kosatsky & Audrey Smargiassi, 2016. "Severe and Moderate Asthma Exacerbations in Asthmatic Children and Exposure to Ambient Air Pollutants," IJERPH, MDPI, vol. 13(8), pages 1-12, August.
    13. Jayasree Basu & Bernard Friedman, 2007. "A re‐examination of distance as a proxy for severity of illness and the implications for differences in utilization by race/ethnicity," Health Economics, John Wiley & Sons, Ltd., vol. 16(7), pages 687-701, July.
    14. repec:rre:publsh:v:39:y:2009:i:2:p:171-87 is not listed on IDEAS
    15. Min Cheng & Li Tao & Yuejiao Lian & Weiwei Huang, 2021. "Measuring Spatial Accessibility of Urban Medical Facilities: A Case Study in Changning District of Shanghai in China," IJERPH, MDPI, vol. 18(18), pages 1-18, September.
    16. Jayasree Basu & Bernard Friedman, 2001. "Preventable illness and out‐of‐area travel of children in New York counties," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 67-78, January.
    17. Muhammed Ziya Paköz & Mehmet Ali Yüzer, 2014. "Determinants of Access to Healthcare: A Survey in Istanbul," ERSA conference papers ersa14p1390, European Regional Science Association.
    18. Akib Khan & Atonu Rabbani, 2015. "Assessing The Spatial Accessibility Of Microfinance In Northern Bangladesh: A Gis Analysis," Journal of Regional Science, Wiley Blackwell, vol. 55(5), pages 842-870, November.
    19. HOSHI, Kisho, 2023. "New Medical Schools, Access to Doctors and Health Outcomes : Evidence from Japan," CEI Working Paper Series 2023-05, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    20. Daniele Fabbri & Silvana Robone, 2010. "The geography of hospital admission in a national health service with patient choice," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1029-1047, September.
    21. Mark Burkey, 2012. "Decomposing geographic accessibility into component parts: methods and an application to hospitals," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 48(3), pages 783-800, June.
    22. Mas, Nuria, 2005. "Managed care and the safety net: More pain for the uninsured?," IESE Research Papers D/596, IESE Business School.
    23. Burkey, M.L. & Bhadury, J. & Eiselt, H.A., 2012. "A location-based comparison of health care services in four U.S. states with efficiency and equity," Socio-Economic Planning Sciences, Elsevier, vol. 46(2), pages 157-163.
    24. Ge Lin & Diane E Allan & Margaret J Penning, 2002. "Examining Distance Effects on Hospitalizations Using GIS: A Study of Three Health Regions in British Columbia, Canada," Environment and Planning A, , vol. 34(11), pages 2037-2053, November.

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