The effects of unemployment and inflation on hospital-based ambulatory care.

Abstract

Data about hospital ambulatory care utilization, unemployment, medical manpower, and population characteristics in the 147 major labor areas* of the United States were obtained from three sources: the tapes of the American Hospital Association's (AHA) Annual Survey from 1969 through 1975, the United States Department of Labor,' and the American Medical Association.2 The AHA tapes were cleaned by linear interpolation of missing data, and by editing for inconsistencies in the classification of total outpatient visits into emergency, clinic, and referred categories. The 147 major labor areas contained 2,440 community hospitals that reported emergency and/or clinic visits in one or more years from 1969 through 1974. Fifty-five per cent of the population of the United States, 85 per cent of all physicians in hospital-based practice, and 71 per cent of the physicians in officebased practice are located in these labor areas. Although hospitals in the major labor areas are, in general, representative of the 5,800 community hospitals nationwide, they are, on the whole, somewhat larger: while they comprise 42 per cent of the nation's community hospitals, they account for 62 per cent of the beds, 63 per cent of the emergency visits, and 79 per cent of the clinic visits. There are proportionately fewer state and local government hospitals