MOBILE TECHNOLOGY IN RURAL HOSPITALS - THE CASE OF THE CT SCANNER

Objective. This study evaluates the relationship between hospital and regional characteristics and the prevalence of mobile computed tomogra phy in rural hospitals. Data Sources and Study Setting. Primary data w ere gathered from all rural hospitals in eight northwestern states (n = 471) in 1991. Secondary data sources include the AHA Annual Survey, the Area Resource File, and HCFA's PPS data sets for 1987-1990. Study Design. Primary data are a single observation taken in the summer of 1 991. Key hospital characteristics include patient volume, distance to the nearest referral center, distance to the nearest hospital, financi al performance, and medical staff size. Key regional variables include beds per unit area, hospitals per unit area, and physician supply. Da ta Collection. A structured telephone interview was conducted with the hospital administrator at each hospital. For many hospitals, detailed information was gathered with additional calls to hospital personnel. Principal Findings. Where hospitals are closely spaced, mobile CT sup pliers are more readily available, and hospitals are more likely to ch oose mobile CT than in areas where hospitals are farther apart. Hospit als may realize economies of scale and scope in their decisions about CT adoption. Conclusions. Transportation costs are an important determ inant of hospital decisions about acquiring CT, but may be less import ant for higher-priced medical technologies. There is no support for th e proposition that rural hospitals compete with referral centers for p atients by purchasing technological equipment.