Journal article
Rural Bypass of Critical Access Hospitals in Iowa: Do Visiting Surgical Specialists Make a Difference?
The Journal of rural health, Vol.34(S1), pp.s21-s29
02/2018
DOI: 10.1111/jrh.12220
PMID: 27677870
Abstract
Purpose
Rural bypass for elective surgical procedures is a challenge for critical access hospitals, yet there are opportunities for rural hospitals to improve local retention of surgical candidates through alternative approaches to developing surgery lines of business. In this study we examine the effect of visiting surgical specialists on the odds of rural bypass.
Methods
Discharge data from the 2011 State Inpatient Databases and State Ambulatory Surgery Databases for Iowa were linked to outreach data from the Office of Statewide Clinical Education Programs and Iowa Physician Information System to model the effect of surgeon specialist supply on rural patients’ decision to bypass rural critical access hospitals.
Findings
Patients in rural communities with a local general surgeon were more likely to be retained in a community than to bypass. Those in communities with visiting general surgeons were more likely to bypass, as were those in communities with visiting urologists and obstetricians. Patients in communities with visiting ophthalmologists and orthopedic surgeons were at higher odds of being retained for their elective surgeries.
Conclusion
In addition to known patient and local hospital factors that have an influence on bypass behavior among rural patients seeking elective surgery, availability of surgeon specialists also plays an important role in whether patients bypass or not. Visiting ophthalmologists and orthopedic surgeons were associated with less bypass, as was having local general surgeons. Visiting general surgeons, urologists, and obstetricians were associated with greater odds of bypass.
Details
- Title: Subtitle
- Rural Bypass of Critical Access Hospitals in Iowa: Do Visiting Surgical Specialists Make a Difference?
- Creators
- Paula A.M Weigel - University of Iowa College of Public HealthFred Ullrich - University of Iowa College of Public HealthMarcia M Ward - University of Iowa College of Public Health
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.34(S1), pp.s21-s29
- DOI
- 10.1111/jrh.12220
- PMID
- 27677870
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Number of pages
- 9
- Grant note
- Federal Office of Rural Health Policy Rural Policy Research Institute Health Resources and Services Administration US Department of Health and Human Services (U1CRH20419)
- Language
- English
- Date published
- 02/2018
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214726902771
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