title: Cross border hospital use: analysis using data linkage across four Australian states.
abstract: OBJECTIVE
  To determine the quality and effectiveness of national data linkage capacity by performing a proof-of-concept project investigating cross-border hospital use and hospital-related deaths.
  
  
  METHODS
  Analysis of person-level linked hospital separation and death registration data of all public and private hospital patients in New South Wales, Queensland and Western Australia and of public hospital patients in South Australia, totalling 7.7 million hospital patients from 1 July 2004 to 30 June 2009.
  
  
  METHODS
  Counts and proportions of hospital stays and patient movement patterns.
  
  
  RESULTS
  223 262 patients (3.0%) travelled across a state border to attend hospitals, in particular, far northern and western NSW patients travelling to Queensland and SA hospitals, respectively. A further 48 575 patients (0.6%) moved their place of residence interstate between hospital visits, particularly to and from areas associated with major mining and tourism industries. Over 11 000 cross-border hospital transfers were also identified. Of patients who travelled across a state border to hospital, 2800 (1.3%) died in that hospital. An additional 496 deaths recorded in one jurisdiction occurred within 30 days of hospital separation from another jurisdiction.
  
  
  CONCLUSIONS
  Access to person-level data linked across jurisdictions identified geographical hot spots of cross-border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.
authors.affiliation: Curtin University, Perth, WA, Australia. Katrina.Spilsbury@curtin.edu.au.
authors.forename: Katrina
authors.initials: K
authors.lastname: Spilsbury
authors.affiliation: WA Department of Health, Perth, WA, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Rosman
authors.affiliation: Curtin University, Perth, WA, Australia.
authors.forename: Janine
authors.initials: J
authors.lastname: Alan
authors.affiliation: Curtin University, Perth, WA, Australia.
authors.forename: James H
authors.initials: JH
authors.lastname: Boyd
authors.affiliation: Curtin University, Perth, WA, Australia.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Ferrante
authors.affiliation: Curtin University, Perth, WA, Australia.
authors.forename: James B
authors.initials: JB
authors.lastname: Semmens
mesh_terms: D001315:Australia; D015331:Cohort Studies; D003625:Data Collection; D004641:Emigration and Immigration; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D012189:Retrospective Studies; D014195:Travel