IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i1p145-156.html
   My bibliography  Save this article

Cross-district utilization of general hospital care in Nova Scotia: Policy and service delivery implications for rural districts

Author

Listed:
  • Hanlon, Neil
  • Skedgel, Chris

Abstract

Acute care regionalization has been pursued in health systems throughout the industrial world as a means of achieving better patient outcomes for specialized services. The evidence in support of this policy direction is compelling, but is primarily based on highly specialized care, such as coronary and cancer treatments. There exists another, largely unintended, form of regionalization that involves the flow of patients from smaller urban and rural settings to major urban centres to obtain routine procedures. Using data from the Nova Scotia Discharge Abstract Database, this paper presents an analysis of cross-district utilization of secondary level acute care. In particular, we examine spatial, demographic and individual healthcare seeking characteristics of those residents who obtained relatively routine hospital care in a different district in 2000/2001, even though an equivalent level of service was available within their home district. Implications of cross-district utilization for the viability of medical service provision in smaller centres in the province and elsewhere are discussed.

Suggested Citation

  • Hanlon, Neil & Skedgel, Chris, 2006. "Cross-district utilization of general hospital care in Nova Scotia: Policy and service delivery implications for rural districts," Social Science & Medicine, Elsevier, vol. 62(1), pages 145-156, January.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:1:p:145-156
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00251-0
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stephen C. Earwicker & David K. Whynes, 1998. "General practitioners' referral thresholds and choices of referral destination: an experimental study," Health Economics, John Wiley & Sons, Ltd., vol. 7(8), pages 711-722, December.
    2. Rosenberg, Mark W. & Hanlon, Neil T., 1996. "Access and utilization: A continuum of health service environments," Social Science & Medicine, Elsevier, vol. 43(6), pages 975-983, September.
    3. Mayer, Jonathan D., 1983. "The distance behavior of hospital patients: A disaggregated analysis," Social Science & Medicine, Elsevier, vol. 17(12), pages 819-827, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Elenka Brenna & Federico Spandonaro, 2014. "Does federalism induce patients’ mobility across regions? Evidence from the Italian experience," DISCE - Working Papers del Dipartimento di Economia e Finanza def009, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    2. Dan L. Crouse & Kyle Rogers & Adele Balram & James T. McDonald, 2022. "The Impact of Rural Hospital Closures and Health Service Restructuring on Provincial- and Community-Level Patterns of Hospital Admissions in New Brunswick," IJERPH, MDPI, vol. 19(12), pages 1-13, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    2. Peter Sivey, 2012. "The effect of waiting time and distance on hospital choice for English cataract patients," Health Economics, John Wiley & Sons, Ltd., vol. 21(4), pages 444-456, April.
    3. Trudy Owens & Nikos Evangelou & David Whynes, 2013. "Rationing and deprivation: disease-modifying therapies for multiple sclerosis in the United Kingdom," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 315-321, April.
    4. Huixia Liu & Linxiu Zhang & Gale Summerfield & Yaojiang Shi, 2009. "A gendered view of reforming health care access for farmers in China," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 1(2), pages 194-211, January.
    5. Propper, Carol & Croxson, Bronwyn & Shearer, Arran, 2002. "Waiting times for hospital admissions: the impact of GP fundholding," Journal of Health Economics, Elsevier, vol. 21(2), pages 227-252, March.
    6. Danxian Wu & Xiaolu Gao & Zhifei Xie & Zening Xu, 2021. "Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective," IJERPH, MDPI, vol. 18(2), pages 1-15, January.
    7. Lin, Swu-Jane & Crawford, Stephanie Y. & Warren Salmon, J., 2005. "Potential access and revealed access to pain management medications," Social Science & Medicine, Elsevier, vol. 60(8), pages 1881-1891, April.
    8. Wang, Lu & Rosenberg, Mark & Lo, Lucia, 2008. "Ethnicity and utilization of family physicians: A case study of Mainland Chinese immigrants in Toronto, Canada," Social Science & Medicine, Elsevier, vol. 67(9), pages 1410-1422, November.
    9. 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.
    10. Simon Jones & Jessica Wardlaw & Susan Crouch & Michelle Carolan, 2011. "Modelling catchment areas for secondary care providers: a case study," Health Care Management Science, Springer, vol. 14(3), pages 253-261, September.
    11. Wojciech Kisiała & Izabela Rącka & Katarzyna Suszyńska, 2022. "Population Access to Hospital Emergency Departments: The Spatial Analysis in Public Health Research," IJERPH, MDPI, vol. 19(3), pages 1-15, January.
    12. Hackl, Franz & Hummer, Michael & Pruckner, Gerald J., 2015. "Old boys’ network in general practitioners’ referral behavior?," Journal of Health Economics, Elsevier, vol. 43(C), pages 56-73.
    13. François Rivest & Pascal Bossé & Silviu Nedelca & Alain Simard, 1999. "Access to Physician Services in Quebec: Relative Influence of Household Income and Area of Residence," Canadian Public Policy, University of Toronto Press, vol. 25(4), pages 453-481, December.
    14. Nordyke, Robert J., 2002. "Determinants of PHC productivity and resource utilization: a comparison of public and private physicians in Macedonia," Health Policy, Elsevier, vol. 60(1), pages 67-96, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:1:p:145-156. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.