Spatial Analysis of Medicare Hospital Utilization in Texas




Ransom, Sandra L.

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The purpose of this investigation was to analyze data and define geographic health distribution patterns at the zip code level in Texas. Health service areas are regions where people, for the most part, utilize a common set of health care providers. The boundaries of the health service areas, as defined in this study, were determined on the basis of flow between where people live and where they seek health care, taking into account natural barriers to that flow. The processes used to develop the health service area boundaries are termed, collectively, small area analysis. The health service area boundaries were determined through a computationally and analytically complex series of procedures which culminated with hierarchical cluster analysis. The output from the series of cluster analyses were used as input to mapping programs which ultimately produced fifty-four health service areas for the state of Texas. Health service areas defined by cluster analysis can be a powerful tool if applied to specific research questions in mapping medical and/or financial data in combination with demographic data. The health service areas for Texas were then utilized in the spatial analysis of health consumption patterns by the mapping of selected DRGs. Population based utilization rates investigated through small area analysis techniques and presented in a graphic display can tell at a glance where potential problems exist. The results of this investigation lay the groundwork for closer examination of variations in utilization of health services among the service areas. Examination of the patterns which become evident using mapping techniques can play a significant part in the quest for quality improvement and cost containment in the health service industry.



health services areas, statistics, medical care, Medicare, spatial analysis


Ransom, S.L. (1994). Spatial analysis of Medicare hospital utilization in Texas (Unpublished thesis). Southwest Texas State University, San Marcos, Texas.


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