University of Connecticut Health Center – John Dempsey Hospital

Spatial Hartford
An Evaluation of Health
System Efficiencies in
Hartford County,
Connecticut
Jeffrey P. Osleeb
Christopher Rappa
Ignite Spatial Hartford – June 22nd 2011
An Evaluation of Health System
Efficiencies in Hartford County,
Connecticut
By
Jeffrey P. Osleeb
and
Christopher Rappa
Department of Geography
University of Connecticut
Presented at NEURISA
June 22, 2011
Motivation
A proposal that the University of Connecticut
Health Center, located in Farmington, CT, be
doubled in size from approximately 250 beds to
500 beds has been approved.
University of Connecticut Health Center and the John Dempsey Hospital
Motivation (Cont)
This expansion proposal is contentious
because:
1. It is not clear how this expansion will
impact the other hospitals in Hartford
County
2. The patient base associated with this
expansion is not well-defined
Objective
The objective of this paper is to evaluate the
hospital healthcare system in Hartford County,
CT. with the objective of understanding the
impact of the expansion.
The following methods are employed:
•Social indicators are developed to determine those
areas where people reside who are at greatest risk.
•Using GIS, patient locations, hospital locations and
the transportation infrastructure is analyzed.
•An allocation model is employed to determine the
optimal hospital catchment areas.
Background
Drawing from established approaches to
social indicator analysis (Firth & Payne,
1996; Greenwald, et al., 1994; NYSCHE,
1997) we define a relevant inventory of
social indicators (i.e., aggregated measures
of community circumstance drawn from
census data) that can be examined
separately and in combination as
descriptors of material of communities
across Hartford County.
Hospital Locations
Hospital Size
L
Census Tracts
Hospitals
County_Boundary
Beds
LL
500
0
L
250
3
50
6
9
Miles
HARTFORD
L
L
L
St. Francis Hospital and Medical Center
Hartford Hospital
L
John Dempsey Hospital
Bristol Hospital
L
L
Hospital of Central Connecticut (New Britain General)
L
Hospital of Central Connecticut (Bradley Memorial)
Hospital Name
Number of
Beds*
Bristol Hospital
134
Hartford Hospital
867
Hospital of Central Connecticut (Bradley Memorial)
84
Hospital of Central Connecticut (New Britain General)
330
John Dempsey Hospital
224
Manchester Memorial Hospital
249
St. Francis Hospital and Medical Center
682
Factor Analysis
Factors
More Likely to Require
Hospitalization
Urban Hispanic
Black
Retirement Age
In Group Quarters
Dependents
Less Likely to Require
Hospitalization
Medical Accessibility
Young Adults
College Graduates
College Students
Hospital Catchment Area Factor
Scores
Hospital
Urban Dependents
Hispanic
In Group
Quarters
Retirement
Age
Black
Bristol Hospital
-0.63
-0.36
-0.22
0.00
-0.66
Hartford Hospital
0.47
0.13
-0.04
0.25
-0.56
Bradley Memorial
-0.60
-0.03
0.00
0.38
-0.35
New Britain General
-0.39
-0.33
0.00
0.53
-1.03
John Dempsey
-1.01
0.11
-0.11
0.41
-0.43
Manchester Memorial
-0.93
-0.31
-0.48
-0.46
0.38
St. Francis Hospital
0.09
0.32
-0.40
0.44
2.51
Allocation Model John Dempsey Pre-Expansion
Comparison of Pre –Expansion and Post
Expansion Allocation
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Comparison of Patient Characteristics Pre
and Post Expansion
Pre-Expansion
Hospital
Post-Expansion
Percent Percent Percent Percent Percent Percent
Black
White Hispanic
Black
White Hispanic
Bristol Hospital
2.5%
92.5%
4.7%
2.7%
92.3%
5.1%
Hartford Hospital
9.5%
72.3%
18.9%
10.3%
70.7%
20.0%
Bradley Memorial
0.7%
96.9%
1.9%
0.7%
97.0%
1.8%
New Britain General
6.1%
81.7%
15.7%
5.9%
82.0%
15.3%
John Dempsey
2.7%
90.9%
4.8%
3.1%
90.0%
5.5%
Manchester Memorial
7.5%
84.3%
5.9%
6.9%
85.0%
5.7%
St. Francis Hospital
23.7%
67.3%
8.4%
27.0%
62.6%
10.1%
Pre-Expansion
Hospital
Post-Expansion
Percent
No Vehicle
Average Median
Household Income
Percent
No Vehicle
Average Median
Household Income
Bristol Hospital
3.58%
$45,389.00
2.75%
$44,769.38
Hartford Hospital
36.28%
$47,635.17
33.57%
$47,320.93
Bradley Memorial
New Britain
General
1.48%
$60,909.57
1.45%
$57,964.33
13.80%
$44,282.70
12.14%
$47,164.92
John Dempsey
4.95%
$68,528.73
12.34%
$64,652.04
Manchester Mem
St. Francis
Hospital
4.48%
$54,121.46
3.66%
$55,584.00
35.43%
$51,321.76
34.10%
$46,227.34
Percent No Vehicle
H
ig
h
Post-Expansion
Lo
w
Pre-Expansion
Conclusions
The John Dempsey with an increase of 250
hospital beds or about a 10% increase in the
total number of beds countywide, does not
appear to have an appreciable impact on the
other hospitals in the county.
John Dempsey Hospital draws more urban
patients with its expansion. Many of these
patients do not own vehicles making it
problematic as to how patients will travel to the
expanded hospital.
The authors wish to thank the University of Connecticut
Large Grant Competition for its support for this project.
Spatial Hartford
An Evaluation of Health
System Efficiencies in
Hartford County,
Connecticut
Jeffrey P. Osleeb
Christopher Rappa
Ignite Spatial Hartford – June 22nd 2011