TY - JOUR
T1 - Evaluating the effectiveness of the Hospital Referral Region (HRR) boundaries
T2 - a pilot study in Florida
AU - Jia, Peng
AU - Wang, Fahui
AU - Xierali, Imam M.
N1 - Funding Information:
We thank the International Institute of Spatial Lifecourse Epidemiology (ISLE) for the research support.
Publisher Copyright:
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Nanjing Normal University.
PY - 2020/7/2
Y1 - 2020/7/2
N2 - The nationwide tertiary hospital catchment areas, known as the Dartmouth Hospital Referral Regions (HRRs), were created based on the 1992–1993 Medicare data in the U.S., to reflect referral patterns of hospitals and hospitalization patterns of patients for specialized medical cares at that time. Nowadays, those outdated HRRs have still been chosen as analytical units in most if not all studies in the U.S. where large and high-level hospital service areas are needed. This pilot study aimed to evaluate whether the HRR boundaries have significantly varied over time in Florida. The Dartmouth method was replicated to construct the contemporary HRRs in Geographic Information Systems with 2011 Florida State Inpatient Database. The contemporary HRRs and Dartmouth HRRs were visually and statistically compared in several function-related aspects. The contemporary HRRs included 38 eligible units, twice the number of (19) Dartmouth HRRs, with a comparable level of self-containment (p = 0.634) on average. This reflects the diffusion of specialized medical services such as cardiovascular surgeries among hospitals in the past 2-3 decades The contemporary HRRs hold values for a variety of health policy themes, including hospital policy-making, optimization of healthcare systems, and measurement of competition in healthcare markets.
AB - The nationwide tertiary hospital catchment areas, known as the Dartmouth Hospital Referral Regions (HRRs), were created based on the 1992–1993 Medicare data in the U.S., to reflect referral patterns of hospitals and hospitalization patterns of patients for specialized medical cares at that time. Nowadays, those outdated HRRs have still been chosen as analytical units in most if not all studies in the U.S. where large and high-level hospital service areas are needed. This pilot study aimed to evaluate whether the HRR boundaries have significantly varied over time in Florida. The Dartmouth method was replicated to construct the contemporary HRRs in Geographic Information Systems with 2011 Florida State Inpatient Database. The contemporary HRRs and Dartmouth HRRs were visually and statistically compared in several function-related aspects. The contemporary HRRs included 38 eligible units, twice the number of (19) Dartmouth HRRs, with a comparable level of self-containment (p = 0.634) on average. This reflects the diffusion of specialized medical services such as cardiovascular surgeries among hospitals in the past 2-3 decades The contemporary HRRs hold values for a variety of health policy themes, including hospital policy-making, optimization of healthcare systems, and measurement of competition in healthcare markets.
KW - GIS
KW - HCUP
KW - HRR
KW - HSA
KW - Hospital referral region
KW - State Inpatient Database
KW - health geography
KW - hospital service area
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U2 - 10.1080/19475683.2020.1798509
DO - 10.1080/19475683.2020.1798509
M3 - Article
AN - SCOPUS:85088962496
VL - 26
SP - 251
EP - 260
JO - Geographic Information Sciences
JF - Geographic Information Sciences
SN - 1947-5683
IS - 3
ER -