Paper series (United Hospital Fund of New York)
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Pap Ser United Hosp Fund N Y · Mar 1993
Caring for neighbors: an examination of nonresident use of New York City hospitals.
In 1989, almost 10 percent of all patients--or nearly 100,000 patients--hospitalized at facilities located in New York City were not city residents. Nonresidents are attracted to the city by the prestige and expertise of the city's hospitals; they are more likely than residents to require the hospitals' most sophisticated and specialized services, ranging from transplantation and coronary bypass surgery to treatment of malignant conditions. The largest numbers of nonresident patients, however, receive care for conditions that are relatively routine, care which would seem to be generally available at suburban hospitals. ⋯ The most highly specialized services can maintain clinical expertise and remain financially viable only if a sufficient number of patients can be attracted from throughout the metropolitan area and beyond. Likewise, the city's hospitals can be confident of fulfilling basic patient care needs only as long as New Yorkers do not look elsewhere for care. With the myriad pressures on our hospitals, the challenge of keeping them inviting and responsive will be formidable, but the construction of modern facilities, emphasis on patient-centered care, cultivation of strong relationships with communities and practitioners, and careful monitoring of patient flows and patient satisfaction should help the city's hospitals continue to attract patients, both from within the city and beyond the city limits.
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In 1984, almost 10 million visits were made to New York City hospital emergency rooms and outpatient departments. Of these, nearly one-quarter were made by children. Almost nine out of ten children using hospital emergency rooms and outpatient departments were either poor or uninsured. ⋯ Access to routine health care by uninsured children is limited by the number of municipal hospital sites, both because children seek care within their home community. More details from the study of poor children and New York City hospitals follow. Data sources and statistical methods are described in an appendix to this report.
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Pap Ser United Hosp Fund N Y · Oct 1986
New York's role as a center for health care: an analysis of nonresident patients served by New York City hospitals.
Patients who reside outside of New York City have long been an important segment of the patient population at New York City hospitals. Each year, as far back as systematic data are available, approximately 10 percent of all patients at New York City hospitals have been non residents. Increasing competition and changing reimbursement policies compel hospitals in New York City to assess their role in caring for these patients and its economic implications. ⋯ At New York University Medical Center and Columbia-Presbyterian Medical Center, nonresidents have higher average charges than residents, but the charge differences are much smaller than the DRG weight differences. Thus, within a given DRG, nonresidents consume fewer resources than residents. Under Medicare's Prospective Payment System bases on DRGs, nonresidents appear to be financially attractive to New York hospitals, based on the experience of New York University Medical Center.