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Rural Bypass for Elective Surgeries.

Paula A M Weigel1, Fred Ullrich1, Chance N Finegan1

  • 1Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa.

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|December 2, 2015
PubMed
Summary
This summary is machine-generated.

Nearly half of rural residents bypass their local Critical Access Hospitals (CAHs) for elective surgeries. Younger patients, those with complex conditions, and individuals insured privately are more likely to bypass, especially low-volume CAHs.

Keywords:
critical access hospitalselective surgeryrural bypass

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Area of Science:

  • Health Services Research
  • Rural Health
  • Surgical Care Access

Background:

  • Elective surgical bypass of Critical Access Hospitals (CAHs) by rural residents is a significant issue impacting hospital finances.
  • Understanding bypass rates and contributing factors is crucial for rural healthcare sustainability.

Purpose of the Study:

  • To determine the rate of elective surgical bypass in rural populations.
  • To identify commonly bypassed surgical procedures and analyze volume distribution among CAHs.
  • To identify factors predicting bypass of rural surgical services.

Main Methods:

  • Analysis of 2011 Healthcare Cost and Utilization Project databases from four states.
  • Examination of elective surgery discharges from inpatient and ambulatory settings.
  • Logistic regression modeling to identify predictors of bypass behavior.

Main Results:

  • A 48.4% bypass rate for elective surgical procedures was observed.
  • Musculoskeletal, eye, and digestive system surgeries were most frequently bypassed.
  • Younger patients, those with higher medical complexity, increased surgical risk, private insurance, and those bypassing low-volume hospitals were more likely to be associated with bypass.

Conclusions:

  • Rural hospitals should enhance outpatient elective surgical services to attract more patients.
  • CAHs experiencing bypass need to analyze and address modifiable factors influencing patient choice.