142nd APHA Annual Meeting and Exposition

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Regional differences in hospital utilization in Iceland 2008-2012

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Sigríður Haraldsdóttir, MA , Department of Health Information, Directorate of Health, Reykjavík, Iceland
With the motivation to support evidence-based spatial organization of health care the aim of this study is to explore potential differences in hospital service utilization by geographic regions in Iceland.

The study utilizes data from the National Patient Register, a standardized database with data on every hospital admission.  Data on all admissions (2008-2012) shorter than 90 days are included. The data includes all discharge diagnoses (ICD10) and surgical procedures (NOMESKO).

We observed differences in hospital inpatient utilization by health districts.  The total annual number of hospital admissions, irrespective of the admitting hospital in 2012 was 119 admissions per 1.000 population residing in the Capital Area (CA) but 158 admissions per 1.000 population residing outside the CA (risk difference of 39 per 1000).  The proportion af admissions within the patient´s residential health district ranged between 50% and 65% but varies between geographical regions . The data further indicate that the distance from district hospital may affect whether residents rely on local hospital services or services in the CA.

The higher hospital admission rates among residents outside the CA may reflect poorer health or poorer availability of specialized outpatient health services in this population. Alternatively, long distances to local health service providers might promote inpatient services for rural patients where they can be easily observed.

Learning Areas:

Provision of health care to the public
Public health administration or related administration
Public health or related research

Learning Objectives:
Evaluate geographic access to hospital inpatient services Discuss evidence-based spatial organization of hospital services Compare regional differences in hospital inpatient services Identify geographic circumstances that relate to use of hopital inpatient services

Keyword(s): Health Care Access, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Im am a health geographer and have been the head of division of Health Information at the Directorate of health in Iceland for many years. I am also enrolled in the doctoral programme in Public health sciences at the University of Iceland. My doctoral work focuses on geographic equity in access to health services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.