abstract: 'ObjectiveThe purpose of this study was to describe the local communities

  served by major teaching hospitals.MethodsUsing a dataset of hospitals

  around the United States provided by the Association of American Medical

  Colleges, we identified major teaching hospitals (MTHs) using the

  Association of American Medical Colleges'' definition of those with an

  intern-to-resident bed ratio above 0.25 and more than 100 beds. We

  defined the local geographic market surrounding these hospitals as the

  Dartmouth Atlas hospital service area (HSA). Using MATLAB R2020b

  software, data from each ZIP Code Tabulation Area from the US Census

  Bureau''s 2019 American Community Survey 5-Year Estimate Data tables were

  grouped by HSA and attributed to each MTH. One-sample t tests were used

  to evaluate for statistical differences between the HSAs and the US

  average data. We further stratified the data into regions as defined by

  the US Census Bureau: West, Midwest, Northeast, and South. One-sample t

  tests were used to evaluate for statistical differences between MTH HSA

  regional populations with their respective US regional

  population.ResultsThe local population surrounding 299 unique MTHs

  covered 180 HSAs and was 57\% White, 51\% female, 14\% older than 65

  years old, 37\% with public insurance coverage, 12\% with any

  disability, and 40\% with at least a bachelor''s degree. Compared with

  the overall US population, HSAs surrounding MTHs had higher percentages

  of female residents, Black/African American residents, and residents

  enrolled in Medicare. In contrast, these communities also showed higher

  average household and per capita income, higher percentages of

  bachelor''s degree attainment, and lower rates of any disability or

  Medicaid insurance.ConclusionsOur analysis suggests that the local

  population surrounding MTHs is representative of the wide-ranging ethnic

  and economic diversity of the US population that is advantaged in some

  ways and disadvantaged in others. MTHs continue to play an important

  role in caring for a diverse population. To support and improve policy

  related to the reimbursement of uncompensated care and care of

  underserved populations, researchers and policy makers must work to

  better delineate and make transparent local hospital markets.'
affiliation: 'Miller, BJ (Corresponding Author), Johns Hopkins Univ Hosp, 600 N Wolfe
  St, Meyer 8-143, Baltimore, MD 21287 USA.

  Gowda, Niraj, Emory Univ, Dept Med, Div Pulm Allergy Crit Care \& Sleep Med, Sch
  Med, Atlanta, GA USA.

  Patel, Nisha M. M., Univ Florida, Dept Med, Div Gen Internal Med, Coll Med, Gainesville,
  FL USA.

  Ellenbogen, Michael I. I., Johns Hopkins Univ, Div Hosp Med, Dept Med, Sch Med,
  Baltimore, MD USA.

  Miller, Brian J. J., Johns Hopkins Univ Hosp, Div Hosp Med, Baltimore, MD 21287
  USA.'
author: Gowda, Niraj and Patel, Nisha M. M. and Ellenbogen, Michael I. I. and Miller,
  Brian J. J.
author-email: 'ngowda2015@gmail.com

  nmpatel012@gmail.com

  mellenb6@jhmi.edu

  brian@brianjmillermd.com'
author_list:
- family: Gowda
  given: Niraj
- family: Patel
  given: Nisha M. M.
- family: Ellenbogen
  given: Michael I. I.
- family: Miller
  given: Brian J. J.
da: '2023-09-28'
doi: 10.14423/SMJ.0000000000001554
eissn: 1541-8243
files: []
issn: 0038-4348
journal: SOUTHERN MEDICAL JOURNAL
keywords: 'academic medical centers; demography; health catchment area; hospital

  service area; teaching hospitals'
keywords-plus: CARE
language: English
month: MAY
number: '5'
number-of-cited-references: '20'
orcid-numbers: Ellenbogen, Michael/0000-0003-0701-8054
pages: 410-414
papis_id: 22519b1976e6f3f3e8b7d0a86378d08f
ref: Gowda2023localmarket
times-cited: '0'
title: The Local Market of Major Teaching Hospitals
type: Article
unique-id: WOS:000975601100006
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '116'
web-of-science-categories: Medicine, General \& Internal
year: '2023'