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Hospitals' community orientation as an influencing variable on outpatient medical service utilization

Jong-Deuk Baek, PH D1, Carleen H. Stoskopf, ScD2, and Yunho Jeon, MS2. (1) Health Services Policy and Management, University of South Carolina, 800 Sumter, columbia, SC 29208, 803-777-2772, baekj@mailbox.sc.edu, (2) School of Public Health, Health Services Policy and Management, University of South Carolina, 800 Sumter, Columbia, SC 29208

Research Objective: To investigate the impact of the degree of a hospital's community orientation on outpatient medical service utilization.

Study Design: The data of this study comes from AHA 2000 hospital data. Nine items are used to measure community orientation and we made a summated scale based on those items (0-9). For outpatient service utilization, the number of outpatient services, excluding emergency room visits and outpatient surgical procedures were used. Control variables are hospital type (ownership), size (number of beds), staffing, number of managed care contracts, and MSA. The percent of Medicare and the percent of uninsured in the county where the hospital is located come from BRFSS 2000. The unit of analysis is the hospital and the analysis includes 638 hospitals.

Principal Findings: Community orientation is significantly associated with outpatient medical service utilization. The more community oriented a hospital is, the more significant the association with an increase in outpatient services and the number of outpatient surgical procedures performed. A hospital that is categorized as a community hospital has a higher community orientation score, and is associated with higher use of outpatient services.

Conclusions: Hospitals with a higher degree of community orientation show greater outpatient utilization than those with lower community orientation after controlling for variables. Hospitals need to be more involved in their communities, and by doing so increase outpatient service utilization. This is concurrent with hospitals' effort to enhance outpatient services to control their operation expenses incurred by inpatient medical services.

Learning Objectives:

Presenting author's disclosure statement:

Not Answered

Managing Health and Leading Improvement: New Directions in Health Administration

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA