Hailey Tran
Hospital Referral Regions (HRRs) are geographic areas created by the Dartmouth Atlas project to define unique healthcare market regions. Each HRR contains at least one hospital that performs major cardiovascular procedures and neurosurgery. There are 306 HRRs in the United States, ranging in size from 121,666 (Bend, Oregon) to 8,891,233 (Los Angeles). These HRRs are used to investigate rural-urban health disparities and provide insights into healthcare markets in the United States.
| Characteristics | Values |
|---|---|
| Number of Hospital Referral Regions (HRRs) | 306 |
| Minimum Population Requirement | 120,000 |
| Localization Index Requirement | At least 65% of hospitalizations of HRR patients should be within the HRR |
| Number of Hospital Service Areas (HSAs) | 3,436 |
| Number of Hospitals Performing Major Cardiovascular Procedures in 1992-93 | 862 |
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What You'll Learn
There are 306 hospital referral regions in the US
Hospital Referral Regions (HRRs) are geographic delineations created by the Dartmouth Atlas of Health Care to define unique healthcare market regions. There are 306 HRRs in the US, ranging in size from 121,666 in Bend, Oregon, to 8,891,233 in Los Angeles. These regions are based on the referral patterns of tertiary medical care, with each HRR containing at least one location where major cardiovascular surgical procedures and neurosurgeries are performed.
HRRs are made up of zip code area groupings, with a minimum population requirement of 120,000. Residents of a given HRR must have at least 65% of their hospital stays within the region. These regions are often used to evaluate inpatient referral patterns and end-of-life care, especially for Medicare decedents. For example, North Carolina and South Carolina are divided into nine and five HRRs, respectively, and these HRRs have shown substantial variation in hospice use rates.
HRRs are also used to measure health care quality, access, and cost for populations, and to evaluate the ability of geographic units to describe patterns of hospital use for patients within them. They are useful for health system planning and can be used for various forms of analysis. For instance, HRR-level modified GPCIs can be calculated to adjust allocated hospital expenditures and provide a more accurate representation of health care resource distribution.
The Dartmouth Atlas of Health Care's 306 HRRs provide a comprehensive framework for understanding and evaluating healthcare markets and referral patterns in the US. These regions are an essential tool for researchers, policymakers, and healthcare providers, helping to identify areas of improvement and ensure equitable access to quality healthcare services.
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HRRs are geographic delineations
Hospital Referral Regions (HRRs) are geographic delineations created by the Dartmouth Atlas of Health Care, an organisation dedicated to studying healthcare markets in the United States. HRRs are used to clearly define unique healthcare market regions. They are made up of zip code area groupings, based on the referral patterns of tertiary medical care.
HRRs are determined by where patients within a given area are referred for cardiovascular surgical procedures and neurosurgery. Each HRR contains at least one hospital that provides these services. HRRs are defined by assigning zip codes to the hospital area where the greatest proportion of Medicare residents are hospitalised. This process is known as Hospital Service Areas (HSAs). There are 3,436 HSAs in the United States.
Once HSAs have been assigned, they are then aggregated into larger-area HRRs. This is done based on where the Medicare enrollees within that HSA access major cardiovascular procedures or neurosurgery. HRRs must meet certain criteria, including a minimum population of 120,000, and residents of a given HRR must have at least 65% of their hospital stays within the HRR.
There are a total of 306 HRRs in the United States. These regions are not constrained by state lines and frequently cross state boundaries. The number of HRRs ranges in size from 121,666 in Bend, Oregon, to 8,891,233 in Los Angeles.
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HRRs are determined by where patients are referred for major procedures
Hospital Referral Regions (HRRs) are geographic areas that represent healthcare markets for tertiary medical care. Each HRR contains at least one hospital that performs major cardiovascular and neurosurgical procedures. The Dartmouth Atlas project, which focuses on studying healthcare markets in the United States, defines HRRs based on where patients within a given area are referred for these major procedures.
The process of determining HRRs involves several steps. Firstly, candidate hospitals and initial HRRs are identified based on the number of major cardiovascular procedures performed on Medicare enrollees. Secondly, the proportion of these procedures performed in each candidate HRR is calculated. Finally, Hospital Service Areas (HSAs) are reassigned or grouped to achieve geographic contiguity, a minimum population of 120,000, and a high localization index, resulting in the final HRRs.
HRRs are important because they help healthcare companies and researchers analyze and understand healthcare utilization, spending, and outcomes in different regions. By considering where patients are referred for major procedures, HRRs provide a more accurate representation of healthcare markets and the flow of patients between regions. This information can be used to identify disparities and improve healthcare access and quality, especially in rural areas.
In total, there are 306 HRRs in the United States, each containing at least one HSA. HSAs are smaller units defined by zip codes, where the majority of Medicare beneficiaries within that zip code are hospitalized. The creation of HRRs and HSAs allows for a more nuanced understanding of healthcare markets and patient referral patterns, which can inform healthcare policy, planning, and resource allocation.
HRRs and HSAs are dynamic entities and may be adjusted over time to reflect changes in healthcare utilization, population demographics, and the availability of healthcare services in different regions. Regular updates to these geographic delineations ensure that healthcare planning and resource allocation remain responsive to the evolving needs of patients and healthcare providers.
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HRRs represent healthcare markets for tertiary hospitals
Hospital Referral Regions (HRRs) are geographic areas created by the Dartmouth Atlas project to characterise where Medicare recipients are admitted for tertiary care. There are 306 HRRs in the US, each containing at least one hospital that performs major cardiovascular procedures and neurosurgery.
HRRs are made up of zip code area groupings based on the referral patterns of tertiary medical care. They have a minimum population requirement of 120,000, and residents of a given HRR must have at least 65% of their hospital stays within the HRR. HRRs are determined by where patients within a given area are referred for cardiovascular surgical procedures and neurosurgery. This means that every HRR contains at least one location where both types of procedures are performed.
The Dartmouth Atlas project identified 862 hospitals that performed at least 10 major cardiovascular procedures on Medicare enrollees in 1992-93. These hospitals were located within 458 HSAs, defining the maximum number of possible HRRs. Further checks verified that all 458 HSAs included at least one hospital performing the specified major neurosurgical procedures.
To achieve geographic contiguity, HSAs were reassigned or further grouped unless major travel routes justified separation. This occurred in only two cases: the New Haven, Connecticut, and Elmira, New York HRRs. The process of aggregating HSAs into HRRs resulted in 306 hospital referral regions, ranging in size from 121,666 (Bend, Oregon) to 8,891,233 (Los Angeles).
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HRRs are made up of zip code groupings
Hospital Referral Regions (HRRs) are geographic delineations created by the Dartmouth Atlas of Health Care to define unique healthcare market regions. There are 306 HRRs in the US, each consisting of zip code area groupings based on referral patterns for tertiary medical care.
HRRs are determined by where patients within a given area are referred for major cardiovascular surgical procedures and neurosurgery. Each HRR contains at least one hospital that performs these procedures, with a minimum population requirement of 120,000. Residents of a given HRR must have at least 65% of their hospital stays within the region.
HRRs are defined by first identifying the hospitals and HRRs where these procedures are performed. The proportion of major cardiovascular procedures performed in each candidate HRR is then calculated. Finally, Hospital Service Areas (HSAs) are reassigned or further grouped to achieve geographic contiguity, a minimum population size of 120,000, and a high localization index.
The Dartmouth Atlas project assigns zip codes to HSAs, which are smaller units based on the hospital where the majority of Medicare beneficiaries within that zip code are hospitalized. HSAs are then aggregated into larger-area HRRs based on where Medicare enrollees access major cardiovascular procedures or neurosurgery. This process results in 3,436 HSAs and 306 HRRs in the US.
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Frequently asked questions
There are 306 HRRs in the US.
HRRs are geographic delineations created by the Dartmouth Atlas of Health Care to define unique healthcare market regions. Each HRR contains at least one hospital that performs major cardiovascular and neurosurgery procedures.
The minimum population size of an HRR is 120,000.
