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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.

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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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Cumulative Percentages of Swiss Population according to ascending HSA LI-ranks
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Figure 9: Cumulative Percentages of Swiss Population according to ascending HSA LI-ranks

Mentions: The LI, a population-based index, gauges the tendency of patients within an HSA to use local hospitals. Plotting the cumulative population counts of HSAs against ranked LIs of HSAs visually demonstrated that 50% of the Swiss population lives in HSAs where at least 65% of hospitalizations occur locally (Figure 9). Likewise, about one fifth of the Swiss population lives in HSAs where less than 50% of hospitalizations occur locally and 25% live in HSAs with a localization of hospital care exceeding 80%.


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)

Cumulative Percentages of Swiss Population according to ascending HSA LI-ranks
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 9: Cumulative Percentages of Swiss Population according to ascending HSA LI-ranks
Mentions: The LI, a population-based index, gauges the tendency of patients within an HSA to use local hospitals. Plotting the cumulative population counts of HSAs against ranked LIs of HSAs visually demonstrated that 50% of the Swiss population lives in HSAs where at least 65% of hospitalizations occur locally (Figure 9). Likewise, about one fifth of the Swiss population lives in HSAs where less than 50% of hospitalizations occur locally and 25% live in HSAs with a localization of hospital care exceeding 80%.

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