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Understanding rural hospital bypass behavior.

Tiffany A Radcliff1, Michelle Brasure, Ira S Moscovice

  • 1Department of Health Services Administration, University of Florida, PO Box 100195, Gainesville, FL 32610-0195, USA. tradclif@hp.ufl.edu

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|July 4, 2003
PubMed
Summary

Rural patients bypass local hospitals at a 30% rate, preferring distant facilities for complex procedures. This rural hospital bypass behavior remained consistent between 1991 and 1996.

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Area of Science:

  • Health Services Research
  • Rural Health
  • Healthcare Access

Background:

  • Rural hospitals offer diverse services, yet residents often seek care elsewhere.
  • This patient bypass phenomenon can lead to financial distress and service reduction in rural facilities.

Purpose of the Study:

  • To analyze rural hospital bypass behavior across seven states.
  • To describe the extent and trends of patients bypassing local rural facilities for inpatient care.

Main Methods:

  • Examined hospital discharge data from 1991 and 1996.
  • Defined bypass as discharge from a facility 15 to 1000 miles from the closest rural hospital.
  • Assessed trends in bypass patterns over time.

Main Results:

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  • An overall rural hospital bypass rate of 30% was observed, with little change between 1991 and 1996.
  • Patients with managed care or commercial insurance exhibited higher bypass rates.
  • Lower bypass rates were seen for Medicare, self-pay patients, and those needing general medical or obstetrical care.

Conclusions:

  • Rural patients and physicians view local hospitals as viable for general care.
  • Distant facilities are preferred for specialized medical and surgical treatments not typically offered by smaller rural hospitals.