Evidence map›Paper›PMID 30149514›Full record

Observational studyInternational journal of environmental research and public health2018

Can Urban-Rural Patterns of Hospital Selection Be Changed Using a Report Card Program? A Nationwide Observational Study.

Tsung-Hsien Yu, Nikolas Matthes, Chung-Jen Wei

Abstract readObservational Study
In one paragraph

Observational study in International journal of environmental research and public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Intervention and Public Policy Pathways to Achieve Health Care Equity.International journal of environmental research and public health · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Tsung-Hsien YuDepartment of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan. ericthyu@ntu.edu.tw.ORCID 0000-0002-6874-989X
Nikolas MatthesDepartment of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. nmatthe1@jhu.edu.
Chung-Jen WeiDepartment of Public Health, Fu-Jen Catholic University, Taipei 242, Taiwan. ph1004@mail.fju.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuiding patients to choose high-quality healthcare providers helps ensure that patients receive excellent care and helps reduce health disparities among patients of different socioeconomic backgrounds. The purpose of this study was to examine and compare the effect of implementing a report-card program on the patterns of hospital selection in patients from different socioeconomic subgroups. Patients undergoing total knee replacement (TKR) surgery were used as the sample population.

methodsA patient-level, retrospective, observational and cross-sectional study design was conducted. Taiwan National Health Insurance claims data were used and all patients in this database who had received TKR between April 2007⁻March 2008 (prior to report-card program implementation) and between April 2009⁻March 2010 (after program implementation) were included. Those patients who were under 18 years of age or who lacked area-of-residence or National Health Insurance premium information were excluded. Travelling distance to the hospital and level of hospital performance were used to evaluate the effect of the report-card program.

resultsA total of 32,821 patients were included in this study. The results showed that patterns of hospital selection varied based on the socioeconomic characteristics of patients. In terms of travelling distance and hospital selection, the performance of urban and higher income patients was shorter and better, respectively, than their rural and lower-income peers both before and after report-card-program implementation. Moreover, although the results of multivariate analysis showed that the urban-rural difference in travelling distance enlarged (by 4.75 km) after implementation of the report-card program, this increase was shown to not be significantly related to this program. Furthermore, the results revealed that implementation of the report-card program did not significantly affect the urban-rural difference in terms of level of hospital performance.

conclusionsA successful report-card program should ensure that patients in all socioeconomic groups obtain comprehensive information. However, the results of this study indicate that those in higher socioeconomic subgroups attained more benefits from the program than their lower-subgroup peers. Ensuring that all have equal opportunity to access high-quality healthcare providers may therefore be the next issue that needs to be addressed and resolved.

Indexed as

Quality of Health CareRural PopulationUrban PopulationAdolescentAdultCross-Sectional StudiesFemaleHealthcare DisparitiesHealth Services AccessibilityHospitalsHumansMaleMiddle AgedPatient PreferenceRetrospective StudiesTaiwandifferencehealthcare-seekingincomereport cardresidential area

Identifiers

PMID30149514
PMCPMC6164887

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.