Imerman, Mark D. Eathington, Liesl Jintanakul, Kanlaya Otto, Daniel
Abstract
This report provides a spatial representation of hospital geography in Iowa and of the decisions of patients to patronize hospitals. It begins with a brief analysis of hospital proximity and hospital proximity’s relationship to population distributions and existing hospital capacity. This is followed with a discussion of hospital capacity as a proxy for the supply of hospital services and the construction of hospital service area gravity models based upon capacity. Patient patronage of hospitals is then presented as a proxy of demand for hospital services, and gravity models are estimated on the basis of patronage. Having defined proxies for both the supply of and demand for hospital services and estimated patronage areas with respect to both, the analysis then turns to an investigation of where patients actually go for health care services. A simple visual analysis is done by mapping patients’ locations of residence and coding residence points to identify hospitals actually visited. The next step is to informally evaluate the expectation that patients will patronize their local (within an estimated service area) or nearest (if they reside outside of any service area) hospital. This is done with respect to type of patient (inpatient or outpatient) and by type of diagnosis. This investigation is based on hospital proximity, size, and patronage rather than qualitative evaluations of healthcare adequacy. Evaluation of health care quality is beyond the expertise of the authors. The analysis is based on visual interpretations and simple groupings of mapped data rather than on geostatistical analysis. The results provide a preliminary evaluation of data sources that have not previously been examined in detail. These preliminary results may identify areas of interest for further study. Data was obtained through the 2002 Iowa Hospital Association Inpatient and Outpatient Databases, which provide information on actual patient patronage of Iowa hospitals. Patient patronage reveals individual decisions made in the context of current health care pricing, quality, and availability.
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Publisher Info
Paper provided by Iowa State University, Department of Economics in its series Staff General Research Papers with number
12630.
Length: 40 pages Date of creation: 22 May 2006 Date of revision: Handle: RePEc:isu:genres:12630
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Find related papers by JEL classification: I0 - Health, Education, and Welfare - - General I1 - Health, Education, and Welfare - - Health L8 - Industrial Organization - - Industry Studies: Services
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