Authors: Chul-Young Roh
Addresses: Department of Public Health, College of Public and Allied Health, Box 70674, Johnson City, TN 37615, USA
Abstract: This study explores the reason rural Medicaid beneficiaries bypass their local rural hospitals even though their local rural hospitals provide the healthcare services that patients are seeking. Conditional logit regression was used to identify the factors that influence rural patients to bypass their local rural hospitals. This study analysed 225,142 hospitalisations of rural Medicaid beneficiaries, controlling for characteristics of patients and hospitals and the distance between local rural hospitals and patients| residences. Results show that rural Medicaid beneficiaries were influenced to choose their hospitals by a combination of hospital attributes, including the number of beds, the number of services, accreditation, network, distance and patient characteristics including health status, total charges, race, gender and age. Policy implications are provided for rural healthcare management and policy from three perspectives: the healthcare providers, the rural community, and the government.
Keywords: hospital choice; hospital attributes; patient characteristics; medicaid beneficiaries; conditional logit regression model; rural healthcare management; rural hospitals; hospital competition; healthcare policy; bypassing behaviours; USA; United States; public policy.
International Journal of Public Policy, 2007 Vol.2 No.3/4, pp.316 - 327
Published online: 23 Mar 2007 *Full-text access for editors Full-text access for subscribers Purchase this article Comment on this article