Preventable illness and out-of-area travel of children in New York counties
研究利用1994年纽约州儿童住院数据，用逻辑回归分析发现保险类型和初级医疗资源可及性显著影响儿童因可预防疾病跨县住院的概率。
The long-distance travellers could be important to any cost-benefit assessment of policies to increase or improve local resources. This study examines the out-of-area hospital admission pattern for patients with Ambulatory Care Sensitive (ACS) conditions, also known as preventable conditions. The availability of local resources play a significant role for hospitalization for these conditions. Despite a growing literature investigating hospital choice, little is known about the effects of resource availabilities in local areas and patient characteristics prompting people to seek care at a longer distance from home for these conditions. Based on hospital discharge data for New York residents (children) admitted to hospitals in New York, Pennsylvania, New Jersey or Connecticut in 1994, the study uses logistic regression to predict travel out of the local area for ACS admission. The actual distance between residence and hospital is a highly skewed and problematic measure, but the crossing of county boundaries is a related and very useful dichotomous measure of distant hospitalization. The study finds a strong association of types of insurance and availability of primary care with episodes of hospitalization for children outside the area of residence, after controlling for severity of illness and several other patient and county characteristics.