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Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression
OBJECTIVES: Medical practice variation is a key target for policy makers aiming to improve the efficiency of healthcare delivery. Studies point to strong regional variation in healthcare utilization in Austria which seems to be a by-product of institutional rules and healthcare service mix rather th...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10596751/ http://dx.doi.org/10.1093/eurpub/ckad160.950 |
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author | Berger, M Zuba, M Simon, J |
author_facet | Berger, M Zuba, M Simon, J |
author_sort | Berger, M |
collection | PubMed |
description | OBJECTIVES: Medical practice variation is a key target for policy makers aiming to improve the efficiency of healthcare delivery. Studies point to strong regional variation in healthcare utilization in Austria which seems to be a by-product of institutional rules and healthcare service mix rather than variance in epidemiology. METHODS: We use a set of routine healthcare data on hospital admissions for depressive episodes (ICD-10 F320-F329) of adult Austrian patients from 2009 to 2014 on the municipality level to explore spatial patterns of supply-induced demand by nearby hospitals (“Roemer's law”) in hospital admission rates. The dataset covers 99,844 hospital episodes of 69,555 patients in 2,114 municipalities. We estimate a random effects spatial autoregressive model to regress log hospital admission rates on hospital supply and urbanicity as proxies for the municipalities’ healthcare service mix alongside a set of relevant socio-economic/-demographic characteristics. PRELIMINARY RESULTS: Hospital admission rates per 1,000 inhabitants in the population for depressive episodes vary strongly between municipalities (min=0, max=37.7, mean=1.9, SD = 1.8). We find higher admission rates in the population of suburban municipalities (0.10, 95%-CI: 0.58 - 0.13) and municipalities with hospitals (0.07, 95%-CI: 0.01 - 0.1), regardless of hospital type and size. The spatial structure suggests positive spill-over effects on the hospital admission rates between neighbouring municipalities. CONCLUSIONS: Our results suggest that high admission rates are a seemingly suburban phenomenon and that healthcare service mix is a driving factor for admission rates. Though it is not clear whether the regional variation in medical practice reflects under- or oversupply of hospital care, promoting timely access to primary care and early-stage treatments may reduce the burden of avoidable hospitalizations for patients and public budgets, and close a gap of unmet need for care of vulnerable populations. KEY MESSAGES: • Hospital admission rates for depression of adults per 1,000 inhabitants in the population for depressive episodes vary strongly between municipalities. • Hospital supply and urbanicity are major driving factors of the spatial patterns in regional varation of hospital admissions. |
format | Online Article Text |
id | pubmed-10596751 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105967512023-10-25 Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression Berger, M Zuba, M Simon, J Eur J Public Health Poster Walks OBJECTIVES: Medical practice variation is a key target for policy makers aiming to improve the efficiency of healthcare delivery. Studies point to strong regional variation in healthcare utilization in Austria which seems to be a by-product of institutional rules and healthcare service mix rather than variance in epidemiology. METHODS: We use a set of routine healthcare data on hospital admissions for depressive episodes (ICD-10 F320-F329) of adult Austrian patients from 2009 to 2014 on the municipality level to explore spatial patterns of supply-induced demand by nearby hospitals (“Roemer's law”) in hospital admission rates. The dataset covers 99,844 hospital episodes of 69,555 patients in 2,114 municipalities. We estimate a random effects spatial autoregressive model to regress log hospital admission rates on hospital supply and urbanicity as proxies for the municipalities’ healthcare service mix alongside a set of relevant socio-economic/-demographic characteristics. PRELIMINARY RESULTS: Hospital admission rates per 1,000 inhabitants in the population for depressive episodes vary strongly between municipalities (min=0, max=37.7, mean=1.9, SD = 1.8). We find higher admission rates in the population of suburban municipalities (0.10, 95%-CI: 0.58 - 0.13) and municipalities with hospitals (0.07, 95%-CI: 0.01 - 0.1), regardless of hospital type and size. The spatial structure suggests positive spill-over effects on the hospital admission rates between neighbouring municipalities. CONCLUSIONS: Our results suggest that high admission rates are a seemingly suburban phenomenon and that healthcare service mix is a driving factor for admission rates. Though it is not clear whether the regional variation in medical practice reflects under- or oversupply of hospital care, promoting timely access to primary care and early-stage treatments may reduce the burden of avoidable hospitalizations for patients and public budgets, and close a gap of unmet need for care of vulnerable populations. KEY MESSAGES: • Hospital admission rates for depression of adults per 1,000 inhabitants in the population for depressive episodes vary strongly between municipalities. • Hospital supply and urbanicity are major driving factors of the spatial patterns in regional varation of hospital admissions. Oxford University Press 2023-10-24 /pmc/articles/PMC10596751/ http://dx.doi.org/10.1093/eurpub/ckad160.950 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Walks Berger, M Zuba, M Simon, J Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title | Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title_full | Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title_fullStr | Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title_full_unstemmed | Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title_short | Suburban Blues: Urbanicity, healthcare service mix and spatial patterns of admissions for depression |
title_sort | suburban blues: urbanicity, healthcare service mix and spatial patterns of admissions for depression |
topic | Poster Walks |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10596751/ http://dx.doi.org/10.1093/eurpub/ckad160.950 |
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