Analysis of patient flows for orthopedic procedures using small area analysis in Switzerland
<p>Abstract</p> <p>Background</p> <p>In general cantons regulate and control the Swiss health service system; patient flows within and between cantons are thereby partially disregarded. This paper develops an alternative spatial model, based upon the construction of ort...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Book |
| Published: |
BMC,
2006-09-01T00:00:00Z.
|
| Subjects: | |
| Online Access: | Connect to this object online. |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | <p>Abstract</p> <p>Background</p> <p>In general cantons regulate and control the Swiss health service system; patient flows within and between cantons are thereby partially disregarded. This paper develops an alternative spatial model, based upon the construction of orthopedic hospital service areas (HSA<sub>O</sub>s), and introduces indices for the analysis of patient streams in order to identify areas, irrespective of canton, with diverse characteristics, importance, needs, or demands.</p> <p>Methods</p> <p>HSA<sub>O</sub>s were constructed using orthopedic discharge data. Patient streams between the HSA<sub>O</sub>s were analysed by calculating three indices: the localization index (% local residents discharged locally), the netindex (the ratio of discharges of nonlocal incoming residents to outgoing local residents), and the market share index (% of local resident discharges of all discharges in local hospitals).</p> <p>Results</p> <p>The 85 orthopedic HSA<sub>O</sub>s show a median localization index of 60.8%, a market share index of 75.1%, and 30% of HSA<sub>O</sub>s have a positive netindex. Insurance class of bed, admission type, and patient age are partially but significantly associated with those indicators. A trend to more centrally provided health services can be observed not only in large urban HSA<sub>O</sub>s such as Geneva, Bern, Basel, and Zurich, but also in HSA<sub>O</sub>s in mountain sport areas such as Sion, Davos, or St.Moritz. Furthermore, elderly and emergency patients are more frequently treated locally than younger people or those having elective procedures.</p> <p>Conclusion</p> <p>The division of Switzerland into HSA<sub>O</sub>s provides an alternative spatial model for analysing and describing patient streams for health service utilization. Because this small area model allows more in-depth analysis of patient streams both within and between cantons, it may improve support and planning of resource allocation of in-patient care in the Swiss healthcare system.</p> |
|---|---|
| Item Description: | 10.1186/1472-6963-6-119 1472-6963 |