Teaming up census and patient data to delineate fine-scale hospital service areas and identify geographic disparities in hospital accessibility

Peng Jia, Xinyu Shi, Imam M. Xierali

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The number of hospital beds per capita, an important measure of equity in healthcare availability and resource allocation, was found to vary across geographic areas in many countries, including the USA. The hospital service areas (HSAs) have proven to be more meaningful spatial units for studying health-seeking behaviors and health resource allocation and service utilization. However, when evaluating the geographical balance in ratios of hospital beds to population (HBtP), no existing HSA delineation methods directly consider the underlying population distribution. Using Geographic Information Systems (GIS), this study incorporated the State Inpatient Database with census data to develop a population-based HSA delineation method. The census-derived HSAs were produced for Florida and were validated by aggregating and comparing with the traditional flow-based HSAs. The difference in current ratios of HBtP between the most over- and under-served HSAs was approximately 60 times. Significant clusters of high and low ratios were found in Miami and Jacksonville metropolitan areas, respectively. Such results may be of interest to relevant stakeholders and contribute to planning and optimization of hospital resource allocation and healthcare policy-making. Furthermore, the discovery of a strong correlation between the numbers of hospital discharges and the population at ZIP code level holds a remarkable potential for affordable population estimation, especially in non-census years.

Original languageEnglish (US)
Article number303
JournalEnvironmental Monitoring and Assessment
Volume191
DOIs
StatePublished - Jun 1 2019

Fingerprint

accessibility
census
Hospital beds
Resource allocation
resource allocation
Health
Population distribution
health care
hospital
service area
population estimation
Geographic information systems
population distribution
Availability
policy making
equity
metropolitan area
Planning
stakeholder

Keywords

  • Accessibility
  • Census
  • Florida
  • GIS
  • HCUP
  • Hospital discharge
  • Hospital service area
  • Regionalization

ASJC Scopus subject areas

  • Environmental Science(all)
  • Pollution
  • Management, Monitoring, Policy and Law

Cite this

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abstract = "The number of hospital beds per capita, an important measure of equity in healthcare availability and resource allocation, was found to vary across geographic areas in many countries, including the USA. The hospital service areas (HSAs) have proven to be more meaningful spatial units for studying health-seeking behaviors and health resource allocation and service utilization. However, when evaluating the geographical balance in ratios of hospital beds to population (HBtP), no existing HSA delineation methods directly consider the underlying population distribution. Using Geographic Information Systems (GIS), this study incorporated the State Inpatient Database with census data to develop a population-based HSA delineation method. The census-derived HSAs were produced for Florida and were validated by aggregating and comparing with the traditional flow-based HSAs. The difference in current ratios of HBtP between the most over- and under-served HSAs was approximately 60 times. Significant clusters of high and low ratios were found in Miami and Jacksonville metropolitan areas, respectively. Such results may be of interest to relevant stakeholders and contribute to planning and optimization of hospital resource allocation and healthcare policy-making. Furthermore, the discovery of a strong correlation between the numbers of hospital discharges and the population at ZIP code level holds a remarkable potential for affordable population estimation, especially in non-census years.",
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