Association of distance between hospitals and volume of shared admissions

• Type of Material: Article
• Authors: Sara Turbow, Emory University; Teg Uppal, Emory University; Howard H. Chang, Emory University; Mohammed Ali, Emory University
• Language: English
• Date: 2022-12-01
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12913-022-08931-1
• Title of Journal or Parent Work: BMC Health Services Research
• Volume: 22
• Issue: 1
• Start Page: 1528
• End Page: 1528
• Grant/Funding Information: No funding was sought or received for this study.
• Keywords: Cross-Sectional Studies; United States; Care fragmentation; Inpatients; Hospitals; Health information exchange; Patient Readmission; Readmission; Hospitalization; Humans; Healthcare market; Retrospective Studies
• Research Categories: Health Sciences, Health Care Management

Abstract

Background: To assess whether decreasing distance between hospitals was associated with the number of shared patients (patients with an admission to one hospital and a readmission to another). Methods: Data were from the Healthcare Cost and Utilization Project’s State Inpatient Databases (Florida, Georgia, Maryland, Utah [2017], New York, Vermont [2016]) and the American Hospital Association Annual Survey (2016 & 2017). This was a cross-sectional analysis of patients who had an index admission and subsequent readmission at different hospitals within the same year. We used unadjusted and adjusted linear regression to evaluate the association between the number of shared patients and the distance between admission-readmission hospital pairs. Results: There were 691 hospitals in the sample (247 in Florida, 151 in Georgia, 50 in Maryland, 172 in New York, 58 in Utah, and 13 in Vermont), accounting for a total of 596,772 admission-readmission pairs. 32.6% of the admission-readmission pairs were shared between two hospitals. On average, a one-mile decrease in distance between two hospitals was associated with of 3.05 (95% CI, 3.02, 3.07) more shared admissions. However, variability between states was wide, with Utah having 0.37 (95% CI 0.35, 0.39) more shared admissions between hospitals per one-mile shorter distance, and Maryland having 4.98 (95% CI 4.87, 5.08) more. Conclusions: We found that proximity between hospitals is associated with higher volumes of shared admissions.