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The changing landscape of hospital capacity in large cities and suburbs: implications
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http://hdl.handle.net/1860/1843
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| Title: | The changing landscape of hospital capacity in large cities and suburbs: implications |
| Authors: | Andrulis, Dennis P.
Duchon, Lisa M. |
| Keywords: | Medicaid ALOS
Poverty
Safety net hospitals
Suburban hospital care
Urban hospital care |
| Issue Date: | 2007 |
| Citation: | Journal of Urban Health, 84(3): pp. 400-414. |
| Abstract: | An analysis of trends in hospital use and capacity by ownership status and
community poverty levels for large urban and suburban areas was undertaken to
examine changes that may have important implications for the future of the hospital
safety net in large metropolitan areas. Using data on general acute care hospitals
located in the 100 largest cities and their suburbs for the years 1996, 1999, and 2002,
we examined a number of measures of use and capacity, including staffed beds,
admissions, outpatient and emergency department visits, trauma centers, and positron
emission tomography scanners. Over the 6-year period, the number of for-profit,
nonprofit, and public hospitals declined in both cities and suburbs, with public
hospitals showing the largest percentage of decreases. By 2002, for-profit hospitals
were responsible for more Medicaid admissions than public hospitals for the 100
largest cities combined. Public hospitals, however, maintained the longest Medicaid
average length of stay. The proportion of urban hospital resources located in high
poverty cities was slightly higher than the proportion of urban population living in
high poverty cities. However, the results demonstrate for the first time, a highly
disproportionate share of hospital resources and use among suburbs with a low
poverty rate compared to suburbs with a high poverty rate. High poverty communities
represented the greatest proportion of suburban population in 2000 but had the
smallest proportion of hospital use and specialty care capacity, whereas the opposite
was true of low poverty suburbs. The results raise questions about the effects of the
expanding role of private hospitals as safety net providers, and have implications for
poor residents in high poverty suburban areas, and for urban safety net hospitals that
care for poor suburban residents in surrounding communities. |
| URI: | http://hdl.handle.net/1860/1843 |
| Appears in Collections: | Faculty Research and Publications (IST)
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