Health> Vol.6 No.9, March 2014

Patient Migration for Hospital Utilization: Case of Iran

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ABSTRACT

Introduction: Adequate information about patient using health care facilities is a critical element in planning activities and allocation resources in health sector. In Iran, with performing family physician plan and attempt to reform referral system, the study of mobility of patients between regions (patient migration) has more importance. The aims of the study are: 1) to describe patients’ migration across cities of Iranian Kerman province; 2) to analyze the role of possible determinants affecting the mobility flows. Methodology: using hospital inpatient records of all public hospitals around Kerman province during 2011, we run logit models that compare patients who were admitted in hospital and received health services in cities where they lived and patients received them out of their local hospitals. We studied 21 patient groups according to ICD10 chapters (Appendix 1) to compute the effect of geographic distance, kind of insurance, number of physiccians involved, hospital bed and patient demographic factors. Results: About 40 percent of hospital admissions in Kerman are emigrant patients that quality or quantity of local provided services didn’t satisfy. Constant negative coefficients of geographic distance, hospitals physician and bed and positive coefficients for insurance in all groups do not show any difference in patient migration, between groups. Discussion: According to results of this research, existence of local services, distance, kind of illness and other factors are not more important than patients’ feeling about services in their migration. Paying no attention to this reality in planning health system reforms, especially referral systems, leads to important problems for health system in equity, patient satisfaction and finance aspects.

Cite this paper

Sabermahani, A. , Ghaderi, H. , Ashrafzadeh, H. , Abolhasani, F. , Barouni, M. , Messina, G. and Nante, N. (2014) Patient Migration for Hospital Utilization: Case of Iran. Health, 6, 836-844. doi: 10.4236/health.2014.69105.

References

[1] Nante, N., Ricciardi, G., Al Farraj, O., Morgagni, S., Siliquini, R., Moirano, F., et al. (2003) Hospital Patient Migration: Analysis Using an Utility Index. Public Health in Europe, 293-316.
[2] Messina, G., Forni, S., Collini, F., Quercioli, C. and Nante, N. (2013) Patient Mobility for Cardiac Problems: A Risk-Adjusted Analysis in Italy. BMC Health Services Research, 13, 56.
[3] Goodridge, D., Hawranik, P., Duncan, V. and Turner, H. (2012) Socioeconomic Disparities in Home Health Care Service Access and Utilization: A Scoping Review. International Journal of Nursing Studies, 1, 1310-1319.
[4] Chernew, M., Scanlon, D. and Hayward, R. (1998) Insurance Type and Choice of Hospital for Coronary Artery Bypass Grafi Surgery. Health Services Research, 33, 447-466.
[5] Hodgkin, D. (1996) Specialized Service Offerings and Patient’s Choice of Hospital: The Case of Cardiac Catheterization. Health Economics, 15, 305-332.
http://dx.doi.org/10.1016/0167-6296(96)00004-5
[6] Gulliford, M. and Morgan, M. (2003) Access to Health Care. New Fetler LAN Routledge, London.
[7] Baker, J.B. (2005) Examining Spatial Patterns of Primary Health Care Utilization in Southern Honduras. University of Cincinnati, Cincinnati.
[8] Buor, D. (2002) Distance as a Predominant Factor in the Utilisation of Health Services in the Kumasi Metropolis, Ghana. GeoJournal, 56, 145-157.
http://dx.doi.org/10.1023/A:1022452311911
[9] Rickettsa, T. and Randolp, R. (2001) Hospitalization Rates as Indicators of Access to Primary Care. Health and Place, 7, 27-38.
[10] Robert, S. (1983) Distance and the Utilization of Health Facilities in Rural Nigeria. Social Science and Medicine, 17, 563-570.
http://dx.doi.org/10.1016/0277-9536(83)90298-8
[11] Penchansky, D. and Thomas, J. (1981) The Concept of Access: Definition and Relationship to Consumer Satisfaction. Medical Care, 19, 127-140.
http://dx.doi.org/10.1097/00005650-198102000-00001
[12] Mooney, G., Hall, J., Donaldson, C. and Gerard, K. (1991) Utilisation as a Measure of Equity: Weighing Heat? Journal of Health Economics, 10, 475-480.
http://dx.doi.org/10.1016/0167-6296(91)90026-J
[13] Bailey, W. and Phillips, D. (1990) Spatial Patterns of Use of Health Services in the Kingston Metropolitan Area, Jamaica. Social Science and Medicine, 30, 1-12.
http://dx.doi.org/10.1016/0277-9536(90)90324-L
[14] Müller, I., Smith, T., Mellor, S., Rare, L. and Genton, B. (1998) The Effect of Distance from Home on Attendance at a Small Rural Health Centre in Papua New Guinea. International Journal of Epidemiology, 27, 878-884.
http://dx.doi.org/10.1093/ije/27.5.878
[15] Roh, C.Y. and Lee, K.H. (2006) Hospital Choice by Rural Medicare Beneficiaries: Does Hospital Ownership Matter. Journal of Health and Human Services Administration, 28, 346-365.
[16] Messina, G., Vigiani, N., Lucia, L. and Nante, N. (2008) Patient Migration among the Italian Regions in 2003. Italian Journal of Public Health, 5, 45-52.
[17] Sabermahani, A., Hadian, M., Ghaderi, H., Barouni, M., Shakibaee, A. and Bahrami, M.A. (2012) Comparing the Efficiency of Kerman Province Towns in Acquiring Human Development Index via Data Envelopment Analysis. Iranian Red Crescent Medical Journal, 14, 248-249.
[18] Ishida, Y., Ohde, S., Takahashi, O., Deshpande, G., Shimbo, T. and Hinohara, S. (2012) Factors Affecting Health Care Utilization for Children in Japan. Pediatrics, 129, 113-119.
http://dx.doi.org/10.1542/peds.2011-1321
[19] Poorreza, A., Khabiry, T. and Arab, M. (2008) Analysing Health Seeking Behavior in Tehran City Population. Health College Journal, 7, 1-13.
[20] Fabbri, D. and Robone, S. (2010) The Geography of Hospital Admission in a National Health Service with Patient Choice. Health Economics, 19, 1029-1047.
http://dx.doi.org/10.1002/hec.1639

  
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