Travel time is better indicator of access than ZIP codes, study suggests

Patients who travel longer distances to emergency facilities are more likely to present with more severe medical conditions, highlighting travel time as a key indicator of healthcare access, according to a study published Jan. 21 in JAMA Network Open.

Researchers at the University of Washington in Seattle analyzed data from 190,311 adults who presented at emergency departments in California and Florida with one of five surgical conditions — appendicitis, diverticulitis, gallbladder inflammation, hernia and bowel obstruction — in 2021.

The study found that patients who traveled farther to an ED were more likely to have more complex conditions. Patients who traveled 60 minutes or more were more likely to require surgery, be admitted to the hospital, undergo interfacility transfer, stay longer and face higher charges. On average, these patients stayed nearly half a day longer in the hospital and had medical charges that were $8,284 higher than those traveling less than an hour. 

These findings highlight the importance of considering travel times when analyzing healthcare access, especially in the context of rural hospital closures, researchers said. While policymakers have historically used ZIP codes to assess the effect of closures, this metric doesn't reflect the actual travel distances to emergency care.

"As opposed to static measures, such as rurality, travel time may serve as a more useful metric to inform policy efforts aimed at preserving access to care amidst rural hospital closures and regionalization," researchers concluded. 

View the full study here.

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