Spatial Access to Emergency General Surgery (EGS) Services and EGS Bypass Behaviors in California

Keywords: Hospital bypass behavior; Emergency General Surgery; spatial access; BYM2 model
Session Type: Virtual Paper Abstract
Day: Friday
Session Start / End Time: 2/25/2022 09:40 AM (Eastern Time (US & Canada)) - 2/25/2022 11:00 AM (Eastern Time (US & Canada))
Room: Virtual 35

Abstract

Hospital bypass behaviors (i.e., people go to faraway hospitals instead of close ones) of Emergency General Surgery (EGS) patients may cause treatment delays and worsened health outcomes. This study aimed to find the associations between EGS bypass behaviors and spatial access to EGS services as well as other factors at the individual level and ZIP Code Tabulation Area (ZCTA) level in California. We used a gravity model to calculate spatial access to EGS services at the ZCTA level. A Byesian hierarchical spatial model was used to access associated variables of EGS bypass while accounting for spatial autocorrelation. Results show that better spatial access to EGS hospitals was associated with lower likelihood of EGS bypass. Other factors such as rural-urban status, health insurance type and race/ethnicity were also related to EGS bypass behaviors. Besides, people with similar EGS bypass behaviors seemed to cluster together due to spatial effect. Our results have important implications for EGS resource allocation, utilization and EGS disparity alleviation.