<p> Heart failure poses a significant public health issue in the United States, consuming a disproportionate share of the Centers for Medicare and Medicaid’s annual expenditures (Ramani, Uber, & Mehra, 2010). The purpose of this retrospective quantitative study is to compare the inpatient mortality and 30-day readmissions for heart failure patients based on the patient’s proximity to the hospital treated at either New York University Hospital (NYU), located in downstate NY with a very high population density, or Albany Medical Center (AMC), located in upstate NY in a less densely populated city. A subgroup analysis of race, socioeconomic status, and gender was completed to attempt to identify potential high risk groups. The hypothesis testing did not find a statistically significant overall difference in regard to 30-day readmission rates between the two hospitals or within any of the subgroup analyses. However, both hospitals had a significantly lower percentage of multiple admissions from patients residing in the distant quartile located farthest from the hospital as compared to heart failure patients residing in the distance quartile nearest the hospital. The study did detect statistically significant inpatient mortality differences in the socioeconomic status subgroup analysis between NYU and AMC as well as a difference in the overall study population. The study results add further empirical evidence to the existence of a “decay effect” of health care service utilization as patient proximity to those services decreases.</p>
| Identifer | oai:union.ndltd.org:PROQUEST/oai:pqdtoai.proquest.com:3648303 |
| Date | 31 January 2015 |
| Creators | Smith, Freling S., II |
| Publisher | University of Phoenix |
| Source Sets | ProQuest.com |
| Language | English |
| Detected Language | English |
| Type | thesis |
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