A number of patients "bypass" their local healthcare providers and seek treatment outside their communities, often traveling longer distances. This pattern is referred to as 'bypass' hereafter. The purpose of this study is to identify policy issues related to bypass in order to offer evidence and guidance to policymakers, hospital administrators, and planners on the location of healthcare resources, the alteration of planning programs, and the adjustment of policies in order to retain patients locally. This study identified factors associated with bypass, reasons that some patients favor external (outside their immediate community) healthcare providers and bypass their local community hospitals, and ways to retain patients locally. This study addressed these issues from the perspective of rural residents who had been hospitalized in the last 12 months or received outpatient care in the last six months. In addition, this study assessed how bypass patterns and travel distances/times impact rural residents' health and their healthcare utilization.

Data were collected through a random telephone-based survey of the general population within a 15-20 mile radius of each of 25 randomly selected critical access hospitals. A sample size of 1,264 valid surveys were collected with about 50 responses from each of the twenty five (25) designated hospitals. Each group of 50 completed surveys included 25 subjects above the age of 18 who had inpatient care in last 12 months and the remaining 25 who had outpatient care in last 6 months.

Some findings from this project have been published in The Journal of Rural Health (Winter 2007).

Publications

• Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention
  Journal Article
  FORHP-funded Individual Grantees
  Date: 2007
  Describes the results of a study to assess the extent of bypass for inpatient care among patients living in Critical Access Hospital (CAH) service areas, and to determine factors associated with bypass, the reasons for bypass, and what CAHs can do to retain patients locally.