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September 13, 2012

Does location matter? Rural patients skip nearby hospitals in favor of urban facilities

Daily Briefing

    A new study found that nearly half of rural Tennesseans bypassed community hospitals in favor of receiving the same treatment at large, urban hospitals.

    Using 2009 commercial claims data from 47,300 inpatient cases, BlueCross BlueShield of Tennessee (BCBST) Health Institute tracked where Tennessee residents went to receive medical care in order to better understand local health care patterns.

    To their surprise, the researchers found that geographic proximity to a health care facility did not significantly influence a patient's decision to obtain care.

    BCBST researchers determined that almost 70% of studied patients traveled beyond the nearest health care facility to receive care. However, many did so to receive more specialized care, such as coronary bypass surgery.

    Still, about 43% of studied patients chose to travel 22.6 miles farther from the closest health care facility, on average, to receive the same medical care at a larger, non-rural hospital.

    In addition, BCBST observed that proximity to a health care facility had no influence on whether a patient elected to receive preventive services or adhere to physician orders. For example, the study found that the average distance from a patient's home to the nearest mammogram facility among women who were due for the test was almost the same among adherent and non-adherent patients.

    Two takeaways from the study

    BCBST researchers offered two conclusions regarding health care access:

      1. In today's mobile culture, distance from a health care facility may not be a significant barrier to access.

      2. Discrepant service capabilities exist between rural hospitals that often lack the funds to invest advanced technologies and larger, non-rural hospitals that have them (Coulter et al., BCBS Health Institute report, September 2012; Chattanoogan Times Free Press, 9/10).

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