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Evaluating and re-demarcating the Hospital Service Areas in Florida |
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| Institution: | 1. Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, MA, USA;2. Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA;3. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;4. General Medicine Division, Department of Medicine, Harvard Medical School, Boston, MA, USA;5. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA;6. Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA;1. School of Civil and Environmental Engineering, Faculty of Engineering, UNSW, Kensington Campus, The University of New South Wales, New South Wales 2052, Australia;2. South Western Emergency Research Institute (SWERI), Ingham Institute, 1 Campbell Street, Liverpool, New South Wales 2170, Australia;3. Biosecurity Program, The Kirby Institute, Faculty of Medicine and Health, The University of New South Wales, New South Wales 2052, Australia |
| Abstract: | The Hospital Service Areas (HSAs) better portray underlying local patterns of hospitalization than administrative units, and offer a promising analysis unit for studies of healthcare market. The widely used Dartmouth HSAs in the U.S. were solely based on Medicare inpatient records about two decades ago. Our analysis used all discharge records from Florida hospitals in the 2011 Healthcare Cost and Utilization Project (HCUP) dataset from the Agency for Healthcare Research and Quality (AHRQ). We first matched Medicare-paid hospitalization records in 2011 to the Dartmouth HSAs for demonstrating the temporal variation of the Medicare-derived HSAs. We then compared the HSA configurations based on the overall hospitalization records to Medicare-derived HSAs in the same year (2011) for assessing the representativeness of the Medicare-derived HSAs. Results indicate the boundaries of the Medicare-derived HSAs have significantly shifted over two decades and are inadequate in representing the overall population. The Huff model was used to generate more solid HSAs than traditional approaches. |
| Keywords: | Hospital Service Area (HSA) Hospital localization index HCUP Distance decay function Huff model Florida |
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