title: Determinants of hospital choice of rural hospital patients: the impact of networks, service scopes, and market competition.
abstract: Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.4%) traveled to urban hospitals for inpatient services. This study is to examine how network participation, service scopes, and market competition influences rural women's choice of hospital for their obstetric care. A conditional logistic regression analysis was used. The network participation (p < 0.01), the number of services offered (p < 0.05), and the hospital market competition had a positive and significant relationship with patients' choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals.
authors.affiliation: Department of Public Health, College of Public and Allied Health, East Tennessee State University, Box 70674, Johnson City, TN 37614-1709, USA. roh@mail.etsu.edu
authors.forename: Chul-Young
authors.initials: CY
authors.lastname: Roh
authors.forename: Keon-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Myron D
authors.initials: MD
authors.lastname: Fottler
mesh_terms: D002755:Choice Behavior; D003120:Colorado; D004465:Economic Competition; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D008389:Marketing of Health Services; D009775:Obstetrics and Gynecology Department, Hospital; D017060:Patient Satisfaction