Developing a flow-based spatial algorithm to delineate hospital service areas
Developing a flow-based spatial algorithm to delineate hospital service areas
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DOI：
10.1016/j.apgeog.2016.08.008
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发表时间：
2016-10-01
影响因子：
4.9
通讯作者：
Jia, Peng
中科院分区：
文献类型：
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作者：
Jia, Peng
医院服务区（HSA）涵盖了当地患者到医院的大部分出行流量，并已被公认为分析当地医院利用率和住院模式的最基本单位。如果某个特定的 HSA 包括多家为其居民提供护理的医院，那么在没有设立 HSA 管理者的情况下，将医院绩效或医疗成本的小范围变化的责任分配给特定医院会很复杂。本研究的目标是在 HSA 单位内以最少的医院数量生产 HSA。只有非常有限的研究与 HSA 划分相关。本研究回顾了划定 HSA 之外更广泛服务区域的现有方法。使用 2011 年佛罗里达州住院患者数据库中的个人出院记录开发并实施了一种名为前往医院算法 (TTHA) 的空间算法。最终输出名为 TTHA 派生的 HSA，与传统方法生成的 HSA 相比，在佛罗里达州多包括 14 个符合条件的分区（92 比 78），两组 HSA 的自我控制程度相当。 TTHA 提供了对医院就诊模式的深入了解，对于划分其他类型的服务和服务区域具有重要价值。 (C) 2016 Elsevier Ltd. 保留所有权利。
Hospital service areas (HSAs) capture most of local patient-to-hospital travel flows, and have been accepted as the most basic unit for analyzing local hospital utilization and hospitalization patterns. If a given HSA includes multiple hospitals providing care for its residents, it is complicated to assign responsibility for small-area variation in hospital performance or healthcare costs to specific hospitals without established HSA managers. The goal of this study is to produce HSAs with the fewest number of hospitals within an HSA unit. Only a very limited number of studies are related to the HSA delineation. This study reviews the existing approaches to delineate a broader range of service areas besides HSAs. A spatial algorithm named Travel-to-Hospital Algorithm (TTHA) was developed and implemented using the individual hospital discharge records from the Florida State Inpatient Database for 2011. The final output, named the TTHA-derived HSAs, included 14 more eligible divisions in Florida than the HSAs produced by the traditional approach (92 vs. 78), with the degree of self-containment comparable between the two sets of HSAs. The TTHA provides insight into the patterns of hospital visits and holds great value for the delineation of other types of service and catchment areas. (C) 2016 Elsevier Ltd. All rights reserved.