Action Needed to Reduce Bypassing of Local Hospitals

March 12, 2008

Bypassing local Critical Access Hospitals in rural areas in favor of care outside the local community may be reduced by changing rural residents' perception of local health care provision and increasing the number of primary care physicians, according to research published in the March/April edition of the Annals of Family Medicine.

WEDNESDAY, March 12 (HealthDay News) -- Bypassing local Critical Access Hospitals in rural areas in favor of care outside the local community may be reduced by changing rural residents' perception of local health care provision and increasing the number of primary care physicians, according to research published in the March/April edition of the Annals of Family Medicine.

Jiexin Liu, Ph.D., of the University of Maryland School of Medicine in Baltimore, and colleagues analyzed data from 1,264 adults who lived within 20 miles of 25 randomly selected Critical Access Hospitals. The participants were surveyed by telephone to ascertain to what extent they bypassed local facilities and what would encourage them to seek care locally.

The rate of bypass of local Critical Access Hospitals ranged from 9 percent to 66 percent, with an overall bypass rate of 32 percent, with limited services and lack of specialty care the most commonly cited reasons, the investigators found. Hospitals in areas with a density of more than 4,500 residents per primary care physician were more likely to be bypassed than those with a density of less than 3,500 residents per physician.

"The sizable variation in bypass rates among this sample of Critical Access Hospital service areas suggests that strategies to reduce bypass behavior should be directed at the local community or facility level," the authors write.

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