D Hartley1, I Moscovice, J Christianson. 1. Edmund S. Muskie Institute of Public Affairs, University of Southern Maine, Portland 04103, USA.
Abstract
OBJECTIVE: This study evaluates the relationship between hospital and regional characteristics and the prevalence of mobile computed tomography in rural hospitals. DATA SOURCES AND STUDY SETTING: Primary data were gathered from all rural hospitals in eight northwestern states (n = 471) in 1991. Secondary data sources include the AHA Annual Survey, the Area Resource File, and HCFA's PPS data sets for 1987-1990. STUDY DESIGN: Primary data are a single observation taken in the summer of 1991. Key hospital characteristics include patient volume, distance to the nearest referral center, distance to the nearest hospital, financial performance, and medical staff size. Key regional variables include beds per unit area, hospitals per unit area, and physician supply. DATA COLLECTION: A structured telephone interview was conducted with the hospital administrator at each hospital. For many hospitals, detailed information was gathered with additional calls to hospital personnel. PRINCIPAL FINDINGS: Where hospitals are closely spaced, mobile CT suppliers are more readily available, and hospitals are more likely to choose mobile CT than in areas where hospitals are farther apart. Hospitals may realize economies of scale and scope in their decisions about CT adoption. CONCLUSIONS: Transportation costs are an important determinant of hospital decisions about acquiring CT, but may be less important for higher-priced medical technologies. There is no support for the proposition that rural hospitals compete with referral centers for patients by purchasing technological equipment.
OBJECTIVE: This study evaluates the relationship between hospital and regional characteristics and the prevalence of mobile computed tomography in rural hospitals. DATA SOURCES AND STUDY SETTING: Primary data were gathered from all rural hospitals in eight northwestern states (n = 471) in 1991. Secondary data sources include the AHA Annual Survey, the Area Resource File, and HCFA's PPS data sets for 1987-1990. STUDY DESIGN: Primary data are a single observation taken in the summer of 1991. Key hospital characteristics include patient volume, distance to the nearest referral center, distance to the nearest hospital, financial performance, and medical staff size. Key regional variables include beds per unit area, hospitals per unit area, and physician supply. DATA COLLECTION: A structured telephone interview was conducted with the hospital administrator at each hospital. For many hospitals, detailed information was gathered with additional calls to hospital personnel. PRINCIPAL FINDINGS: Where hospitals are closely spaced, mobile CT suppliers are more readily available, and hospitals are more likely to choose mobile CT than in areas where hospitals are farther apart. Hospitals may realize economies of scale and scope in their decisions about CT adoption. CONCLUSIONS: Transportation costs are an important determinant of hospital decisions about acquiring CT, but may be less important for higher-priced medical technologies. There is no support for the proposition that rural hospitals compete with referral centers for patients by purchasing technological equipment.