title: Application of a similarity index to state discharge abstract data to identify opportunities for growth of surgical and anesthesia practices.
abstract: BACKGROUND
  Most surgical and anesthesia groups are interested in expanding their practices and recruiting more patients. Methods have been developed to help hospitals identify surgical specialties with the potential for growth by determining whether the hospital is performing fewer of certain types of procedures than expected in a given specialty. However, these methods are not appropriate for physicians who may practice at more than one hospital and want to determine the potential for growth in their regions.
  
  
  METHODS
  We examined potential markets for growth of surgical and anesthesia practices in Iowa and New York State using state discharge abstract data. Several patient demographic groups and several surgical specialties were examined. Each state was divided into regions, and data were analyzed three ways: (1) A similarity index compared each region to the rest of the state. (2) The number of procedures performed on patients who left their home regions for care was determined. (3) A similarity index compared procedures performed on patients who left their home regions for care with procedures performed on patients who remained within their home regions.
  
  
  RESULTS
  The methods successfully identified several geographic regions with previously unrecognized growth potential. Access to care was limited in these regions. The methods correctly showed few opportunities for growth in geographic regions where expansion was already known to be unlikely.
  
  
  CONCLUSIONS
  A count of the number of procedures performed on patients who left their home regions, in combination with the similarity index, is a useful method for screening state discharge abstract data to identify geographic regions where surgical and anesthesia practices could grow.
authors: Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa 52242, USA.
authors: Ruth E
authors: RE
authors: Wachtel
authors: Elisabeth U
authors: EU
authors: Dexter
authors: Franklin
authors: F
authors: Dexter
mesh_terms: D000369:Aged, 80 and over; D000776:Anesthesiology / Q000639:trends; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007484:Iowa; D009518:New York; D010351:Patient Discharge / Q000639:trends; D011216:Practice Management, Medical / Q000639:trends; D013514:Surgical Procedures, Operative / Q000639:trends