Hospital and demographic characteristics associated with inpatient neurological services in the United States

Abstract

Objective: To determine nationwide availability and factors associated with inpatient neurological services.

Patients and methods: Using the 2011 American Hospital Association survey, we determined the proportion of hospitals that provided inpatient neurological services. Demographic and household data from the 2010 national census and survey results were utilized to determine regional factors associated with the availability of inpatient neurologic services. Using rate ratios, the association was estimated using Poisson regression. Hospitals lacking emergency departments or with a bed size of less than 25 beds were excluded to focus on acute care facilities with the potential to have subspecialty services.

Results: Of 3969 hospitals that completed the survey, 2017 (65%) provided inpatient neurological services. Hospitals with Joint Commission (JC) accreditation were 1.35 times more likely (95% CI: 1.16-1.57) to have inpatient neurological services. Compared to small hospitals (bed size 25-36), large hospitals (bed size 246-2264) were 4.53 times more likely (95% CI: 2.79-7.35) to provide inpatient neurological services. Hospitals that were the sole community provider or were non-federal governmental hospitals had a lower probability of providing inpatient neurological services with rate ratio of 0.65 (95% CI: 0.5-0.84) and 0.81 (95% CI: 0.7-0.94), respectively.

Conclusions: Approximately two-thirds of hospitals in this nationwide survey provided hospital-based neurological services. Larger hospitals and those with JC accreditation were more likely to provide neurological services, whereas small hospitals, sole community providers, and non-federal governmental hospitals were less likely to provide them.

Keywords: Health services research; Hospitals; Neurological services; Outcome research; Quality improvement.