Impact of patients' socioeconomic status on the distance travelled for hospital admission in the English National Health Service.
OBJECTIVE
To compare the distances travelled for inpatient treatment in England between electoral wards prior to the introduction of a policy to extend patient choice and to consider the impact of patients' socio-economic status.


METHODS
Using Hospital Episode Statistics for 2003-04, the distance from a patient's residence to a National Health Service hospital was calculated for each admission. Distances were summed to electoral ward level to give the distribution of distances travelled at ward level. These were analysed to show the distance travelled for different admission types, ages of patient, rural/urban location, and the socioeconomic deprivation of the population of the ward.


RESULTS
There is considerable variation in the distances travelled for hospital admission between electoral wards. Some of this is explained by geographical location: individuals living in more rural areas travel further for elective (median 27.2 versus 15.0 km), emergency (25.3 versus 13.9 km) and maternity (25.0 versus 13.9 km) admissions. But individuals located in highly deprived wards travel less far, and this shorter distance is not explained simply by the closer location of hospitals to these wards.


CONCLUSIONS
Before the introduction of more patient choice, there were considerable differences between individuals in the distances they travelled for hospital care. An increase in patient choice may disproportionately benefit people from less deprived areas.
Propper
Carol
C
Department of Economics and CMPO, University of Bristol, Bristol, UK. carol.propper@bris.ac.uk
Damiani
Michael
M
Leckie
George
G
Dixon
Jennifer
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D004739:England; D017050:Episode of Care; D005260:Female; D005843:Geography; D018166:Health Care Reform; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D010343:Patient Admission; D016012:Poisson Distribution; D011247:Pregnancy; D019035:Rural Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D012923:Social Class; D013222:State Medicine / Q000458:organization & administration*; D014186:Transportation; D019037:Urban Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution