Geography and Travel Distance Impact Emergency Department Visits
| Autor: | Haiping Li, Jane Garb, Richard B. Wait, Philip L. Henneman, Geoffrey A. Capraro, Howard A. Smithline |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Urban Population Population Health Services Accessibility Block group Patient Admission Risk Factors medicine Humans education Retrospective Studies Mile Academic Medical Centers Travel education.field_of_study Geography business.industry Incidence Spatial interaction Emergency department Patient Visit United States Census block Emergency medicine Emergency Medicine Referral center Female Emergency Service Hospital business Demography |
| Zdroj: | The Journal of Emergency Medicine. 40:333-339 |
| ISSN: | 0736-4679 |
| DOI: | 10.1016/j.jemermed.2009.08.058 |
| Popis: | Background: Little has been written about the geographic basis of emergency department (ED) visits. Objective: The objective of this study is to describe the impact of geography on ED visits. Methods: A retrospective analysis was conducted of ED visits during a 1-year period at a single institution using spatial interaction analysis that models the pattern of flow between a series of origins (census block groups) and a destination (ED). Patients were assigned to census block groups based upon their verified home address. The study hospital is the only Level I trauma, pediatric, and tertiary referral center in the area. There are 11 other hospitals with EDs within a 40-mile radius. Each patient visit within this radius, including repeat visits, was included. Patients with an invalid home address, a post office box address, or those who lived outside a 40-mile radius were excluded. ED visits per 100 population were calculated for each census block group. Results: There were 98,584 (95%) visits by 63,524 patients that met study inclusion criteria. Visit rates decreased with increasing distance from the ED (p < 0.0001). Nineteen percent of patients lived within 2 miles, 48% within 4 miles, and 92% within 12 miles of the ED. The Connecticut border, 7 miles south of the ED (p < 0.0001), the Connecticut River, 1 mile west of the ED (p < 0.0001), and the presence of a competing ED within 1 mile (p < 0.0001) negatively impacted block group ED visit rates. Travel distance was related to the percentage of visits that were high acuity (p < 0.0001), daytime (p < 0.01), or resulted in admission (p < 0.0001). Conclusions: Geography and travel distance significantly impact ED visits. |
| Databáze: | OpenAIRE |
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