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Elderly New Yorkers Tend to Use Local Hospitals Even When Severely Ill

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Research Alert: August 3, 2000

According to a new study by the U.S. Agency for Healthcare Research and Quality (AHRQ), old age is the strongest predictor of where New Yorkers will go for hospital care. No matter where elderly people live in the Empire State—in completely rural counties, rural counties adjacent to metropolitan areas or within metropolitan areas—advancing age makes them less likely to travel outside their home counties for hospital care even when they are severely ill.

The study also found that New Yorkers on Medicaid and those with no health insurance also tended to travel less for hospital care, regardless of where they lived. The same held true for nonwhite New Yorkers. Most other New Yorkers tended to seek admission to hospitals outside their home counties and even in neighboring states when severely ill.

AHRQ's Joy Basu, Ph.D., and former AHRQ researcher James Cooper, M.D. tracked hospitalizations of New York residents in their home state and in neighboring New Jersey, Pennsylvania and Connecticut for "ambulatory-sensitive" conditions—diseases, such as asthma, heart failure and angina, that generally should not require hospitalization if managed well at the primary care level.

Overall, 11 percent of New Yorkers living in completely rural areas were admitted to hospitals outside their county of residence. Most of them (8 percent) were hospitalized in facilities in other rural counties. Only 3 percent went to metropolitan-area hospitals. New Yorkers living in "metro-adjacent" rural areas were the ones admitted most frequently to hospitals outside their county of residence.

The study involved nearly 250,000 hospital discharges in 1994 for patients from 58 New York counties, excluding the Bronx, New York County (Manhattan), Queens County and Kings County.

The data came from the AHRQ's Healthcare Cost and Utilization Project, a federal, state, private industry partnership to build a standardized, multi-state health care data system for health care research.

Details are in "Out-of-Area Travel from Rural and Urban Counties: A Study of Ambulatory Care-Sensitive Hospitalizations for New York State Residents," by Drs. Basu and Cooper. The article was published in the Spring 2000 issue of the Journal of Rural Health (Volume 16, issue no. 2).

AHRQ is the lead federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, improve patient safety, address medical errors and broaden access to essential services.

Editor's Note: AHRQ's newly redesigned Web site now includes a special section for reporters. Go to for easier access to the latest news and information about AHRQ research and products.

For more information, contact AHRQ Public Affairs, (301) 427-1364: Bob Isquith, (301) 427-1539 (

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