NEWS

State’s hospitals are keeping health care close to home, according to report

By PATRICK HOGAN
UNC News Services

CHAPEL HILL -- More than half of inpatients discharged from North Carolina acute-care hospitals for both general medical-surgical and maternity care in fiscal 2000 lived within eight miles of their hospital, according to a new report from the University of North Carolina at Chapel Hill’s Cecil G. Sheps Center for Health Services Research.

In addition, 91 percent of patients received hospital treatment within 35 miles of their homes during the year, which began Oct. 1, 1999, and ended Sept. 30, 2000.

"Understanding how far people must travel for different types of health care is important for planning facilities and services in North Carolina," said Dr. Sandra B. Greene, senior research fellow with the Sheps Center and member of the North Carolina State Health Coordinating Council. "Patients prefer to receive care close to home. However, from a cost and quality perspective, it is not realistic to provide complex medical services in every community."

The report, "Patient Origin and Distance to Care: Analysis of the North Carolina Hospital Discharge Database, Fiscal Year 2000," also examines the distance patients must travel to receive open-heart surgery. Though only 21 of North Carolina’s 118 general acute-care hospitals are licensed to perform the procedure, the median distance traveled by patients seeking open-heart care was only 20.3 miles. Ninety percent of patients in the report traveled 65 miles or less to receive open-heart care.

The Sheps Center’s report also suggested that reliance on local or regional health-care sites is influenced by the size and capability of local hospitals. As a result, the state’s largest hospitals and academic medical centers provide care to patients far beyond their regional areas and draw patients from numerous counties across North Carolina.

As illustrated on a map in the report, what follows is a "hub-and-spoke" pattern around the large medical centers, indicating the travel patterns of patients seeking hospital care. In general, Mission St. Joseph’s Health System in Asheville draws patients from the state’s western counties, while Pitt County Memorial Hospital in Greenville cares for patients from the eastern half of the state.

The four academic medical centers in the middle of the state – Carolinas Medical Center in Charlotte, Duke University Health System in Durham, North Carolina Baptist Hospitals in Winston-Salem and UNC Hospitals in Chapel Hill – draw patients from numerous counties across North Carolina.

The report was prepared by the Sheps Center with funding provided by the North Carolina Department of Health and Human Services’ Division of Facility Services. Report data were obtained from the North Carolina Hospital Inpatient Discharge Database as reported by hospitals to Solucient. Psychiatric, rehabilitation and substance abuse hospitals were not included in the analysis, nor were discharged patients who were not residents of North Carolina.

Copies of the brief may be found in electronic format at www.shepscenter.unc.edu/research_programs/health_policy/. For more information, call Susan Dyson at (919) 966-7922.

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(Hogan, from Louisville, Ky., is a senior journalism and mass communication major at UNC.)

Sheps Center contact: Susan Dyson, (919) 966-7922