Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention

Liu, Jiexin Jason; Bellamy, Gail; McCormick, Melissa

doi:10.1111/j.1748-0361.2006.00063.x

Cited by 55 publications

(53 citation statements)

References 20 publications

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“…Also, the findings of this research do not correspond with the research who assert that general hospital patients are influenced most by accessibility of the hospital and actual consultation time with doctors, according to the study on factors that affect the selection of general hospital patients and their satisfaction [8,9,10]. The disparities between this research and previous researches may come from the fact that there is a difference in the utilization of medical service between common patients and cancer patients in our country.…”

Section: Discussion and Resultscontrasting

confidence: 85%

How the Factors of Hospital Choice of Cancer Patients Affect Customer Satisfaction

Yang¹,

Yoon²

2015

IJBSBT

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Section: Discussion and Resultscontrasting

confidence: 85%

How the Factors of Hospital Choice of Cancer Patients Affect Customer Satisfaction

Yang¹,

Yoon²

2015

IJBSBT

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“…[1][2][3] This category also includes referrals to nonlocal professionals made by local physicians or local hospitals. 4 It is important for rural professionals and policy makers to understand the extent to which rural patients bypass their local services and what community and hospital characteristics affect residents' decision to do so, as well as suggestions patients themselves offer to enable hospitals to retain them locally.…”

Section: By Pa S Sing Lo C a L Pr Im A Ry C A R Ementioning

confidence: 99%

“…1,2,[4][5][6][7][8][9][10][11] Patients covered by either commercial or managed care insurers have higher bypass rates than patients covered by other types of payers. 12 The elderly bypass local care less frequently, 1,2,4,10,11,13,14 and working men do so more frequently. 2,15 Diagnosis and severity of illness are also related to bypass.…”

Section: By Pa S Sing Lo C a L Pr Im A Ry C A R Ementioning

confidence: 99%

“…In addition, only 2 studies of this phenomenon have surveyed patients directly. 4,7 These studies found that patients bypassing local care would have used the local hospital if the required services had been available. Many respondents suggested that increasing the number of physicians would help retain more patients locally.…”

Section: By Pa S Sing Lo C a L Pr Im A Ry C A R Ementioning

confidence: 99%

See 1 more Smart Citation

Bypass of Local Primary Care in Rural Counties: Effect of Patient and Community Characteristics

Liu¹,

Bellamy²,

Barnet³

et al. 2008

The Annals of Family Medicine

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PURPOSE This national study sought information from rural patients (1) to assess the prevalence of bypass, a pattern of seeking health care outside the local community; (2) to examine the impact of locally available primary care physicians (PCPs) and hospital size on the odds of bypass; and (3) to identify patient demographic and geographic factors associated with bypass. This study also ascertained the reasons patients give for bypass and their suggestions for how hospitals can retain patients locally. RESULTS Overall, 32% of respondents bypassed local primary care; the rate ranged from 9% to 66% across the Critical Access Hospital service areas. Factors associated with bypass included age, education, marital status, satisfaction with the local hospital, admission to a hospital in the past 12 months, hospital size, and local density of PCPs. Compared with residents in areas with a higher density of PCPs (≤3,500 residents per PCP), residents in areas with a low density (>4,500 residents per PCP) were more likely to bypass local care (odds ratio, 1.58; 95% confi dence interval, 1.02-2.46). Lack of specialty care and limited services were most frequently mentioned as reasons why patients bypassed local hospitals. METHODS CONCLUSIONSThe sizable variation in bypass rates among this sample of Critical Access Hospital service areas suggests that strategies to reduce bypass behavior should be directed at the local community or facility level. Changing rural residents' perception of their local care, helping them gain a better understanding of the function of primary care, and increasing the number of PCPs might help hospitals retain patients and rural communities stay healthy.

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“…To help preserve access to hospital care for rural residents, the Medicare program established a number of special inpatient reimbursement categories for rural hospitals (1,2), which were designed to help rural hospitals overcome the financial hurdles they face primarily due to their low volume. But, even with these programs, rural hospitals can maintain financial viability only if a sufficient number of residents in their communities receive their inpatient care locally rather than elsewhere (3).…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Rural Residents' Utilization of Urban Hospitals

Hall¹,

Marsteller²,

Owings³

2010

PsycEXTRA Dataset

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Objective-To examine, using nationally representative data, which patient, hospital, and county characteristics influence rural residents' urban hospitalization.Methods-Rural residents hospitalized in urban hospitals (crossovers) are compared with those hospitalized in rural hospitals (noncrossovers). National Hospital Discharge Survey data were merged with Area Resource File and Centers for Medicare & Medicaid Services data to study rural inpatients' characteristics; hospital descriptors; and county or state socioeconomic and health service variables. Multivariate logistic regression analysis identified covariates of the likelihood of being a crossover.Findings-About one-third of the rural resident hospitalizations in 2003 were in urban hospitals. Other factors constant, those requiring greater resources had higher odds of crossing over, as did younger inpatients, those transferred from other hospitals, receiving surgery, and with mental diagnoses or congenital anomalies. Males, emergency admissions, and intervertebral disk disorder inpatients had lower odds of crossing over compared with those who were not in these categories. Crossover patients' hospitals had higher Medicare case mix indices than hospitals used by noncrossovers. Rural inpatients in government hospitals, rather than proprietary or non-profit hospitals, had greater odds of crossing over, as did rural patients from counties with lower population density, fewer hospital beds, more hospitals, more commuters, and lower per capita income compared with those in other categories.Conclusions-Rural hospitals continue to be an important source of inpatient care, but rural residents travel to urban hospitals in some specific instances.

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Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention

Cited by 55 publications

References 20 publications

How the Factors of Hospital Choice of Cancer Patients Affect Customer Satisfaction

How the Factors of Hospital Choice of Cancer Patients Affect Customer Satisfaction

Bypass of Local Primary Care in Rural Counties: Effect of Patient and Community Characteristics

Factors Influencing Rural Residents' Utilization of Urban Hospitals

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