Patient population of a referral medical center

An analysis has been made of the patient population attending North Carolina Memorial Hospital (NCMH), primarily a referral center, in a nine-week period, with particular attention paid to county of residence of patients and to the type of care being obtained (consultative or continuing). Patients' use of NCMH, in relation to the population of their county of residence, showed a variability that could not be explained completely by distance from NCMH. Evidence is presented suggesting that the extent of other medical care personnel and facilities in the home county had little influence on utilization rates for this referral center. One significant determinant of increased utilization of NCMH appeared to be lack of county welfare funds for payment for medical care of its indigent population. In a review of the medical records of a five percent random sample of the total patient population, it was found that approximately 16 percent of the patients were probably receiving primary, continuing care at NCMH, i.e., care usually provided by family or personal physicians. Among Orange county residents approximately 35 percent were in the primary care group. Such patients had an average 6.3 visits per year to NCMH clinics and emergency room, compared to 2.3 visits per year for patients receiving consultative care. It is suggested that continuing tabulation of hospital utilization data, in addition to the usual statistics on visits and admissions, would be of value in recognizing changing patterns of utilization and in determining the type of service best suited to each individual patient.