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Hospital service areas -- a new tool for health care planning in Switzerland.

Klauss G, Staub L, Widmer M, Busato A - BMC Health Serv Res (2005)

Bottom Line: In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models.Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants.They will be used to study variation phenomena in Swiss health care.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Evaluative Research in Orthopaedic Surgery (IEFO), University of Bern, Stauffacherstrasse 78, CH-3014 Bern, Switzerland. Gunnar.Klauss@memcenter.unibe.ch

ABSTRACT

Background: The description of patient travel patterns and variations in health care utilization may guide a sound health care planning process. In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models. This paper presents the methodology to create and characterize population-based hospital service areas (HSAs) for Switzerland.

Methods: We employed federal hospital discharge data to perform a patient origin study using small area analysis. Each of 605 residential regions was assigned to one of 215 hospital provider regions where the most frequent number of discharges took place. HSAs were characterized geographically, demographically, and through health utilization indices and rates that describe hospital use. We introduced novel planning variables extracted from the patient origin study and investigated relationships among health utilization indices and rates to understand patient travel patterns for hospital use. Results were visualized as maps in a geographic information system (GIS).

Results: We obtained 100 HSAs using a patient origin matrix containing over four million discharges. HSAs had diverse demographic and geographic characteristics. Urban HSAs had above average population sizes, while mountainous HSAs were scarcely populated but larger in size. We found higher localization of care in urban HSAs and in mountainous HSAs. Half of the Swiss population lives in service areas where 65% of hospital care is provided by local hospitals.

Conclusion: Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants. HSAs and health utilization indices provide valuable information for health care planning. They will be used to study variation phenomena in Swiss health care.

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Related in: MedlinePlus

Localization Indices (in %) of Swiss HSAs.
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Figure 4: Localization Indices (in %) of Swiss HSAs.

Mentions: Figure 4 depicts a map of the localization indices of HSAs. The HSA with the highest LI was Geneva (LI = 96%), the HSA with the lowest LI (of 28%) was situated in the Swiss Midlands. Three geographic patterns emerged: (1) HSAs of mountainous regions had above-average LIs; (2) HSAs with below-average LIs were predominantly highly developed region; (3) HSAs which incorporated any of the 14 large urban centres or agglomerations showed above-average LIs (mean = 75.7%) compared to the remaining HSAs (mean = 56.1%; p < 0.0001).


Hospital service areas -- a new tool for health care planning in Switzerland.

Klauss G, Staub L, Widmer M, Busato A - BMC Health Serv Res (2005)

Localization Indices (in %) of Swiss HSAs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1131901&req=5

Figure 4: Localization Indices (in %) of Swiss HSAs.
Mentions: Figure 4 depicts a map of the localization indices of HSAs. The HSA with the highest LI was Geneva (LI = 96%), the HSA with the lowest LI (of 28%) was situated in the Swiss Midlands. Three geographic patterns emerged: (1) HSAs of mountainous regions had above-average LIs; (2) HSAs with below-average LIs were predominantly highly developed region; (3) HSAs which incorporated any of the 14 large urban centres or agglomerations showed above-average LIs (mean = 75.7%) compared to the remaining HSAs (mean = 56.1%; p < 0.0001).

Bottom Line: In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models.Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants.They will be used to study variation phenomena in Swiss health care.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Evaluative Research in Orthopaedic Surgery (IEFO), University of Bern, Stauffacherstrasse 78, CH-3014 Bern, Switzerland. Gunnar.Klauss@memcenter.unibe.ch

ABSTRACT

Background: The description of patient travel patterns and variations in health care utilization may guide a sound health care planning process. In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models. This paper presents the methodology to create and characterize population-based hospital service areas (HSAs) for Switzerland.

Methods: We employed federal hospital discharge data to perform a patient origin study using small area analysis. Each of 605 residential regions was assigned to one of 215 hospital provider regions where the most frequent number of discharges took place. HSAs were characterized geographically, demographically, and through health utilization indices and rates that describe hospital use. We introduced novel planning variables extracted from the patient origin study and investigated relationships among health utilization indices and rates to understand patient travel patterns for hospital use. Results were visualized as maps in a geographic information system (GIS).

Results: We obtained 100 HSAs using a patient origin matrix containing over four million discharges. HSAs had diverse demographic and geographic characteristics. Urban HSAs had above average population sizes, while mountainous HSAs were scarcely populated but larger in size. We found higher localization of care in urban HSAs and in mountainous HSAs. Half of the Swiss population lives in service areas where 65% of hospital care is provided by local hospitals.

Conclusion: Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants. HSAs and health utilization indices provide valuable information for health care planning. They will be used to study variation phenomena in Swiss health care.

Show MeSH
Related in: MedlinePlus