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Show bias can not be ruled out, we have no evidence that the low response rate biased the findings. Conclusions A sample of Utah physicians demonstrated significant variability in the self-reported decision to admit an ACSC case to the hospital, based on non-medical factors. Factors such as no family support at home, distance from care, and family preference to hospitalize increased the reported likelihood of hospitalization in rural/frontier areas. This suggests that identification of feasible, cost-effective alternatives to hospitalization may be worthwhile, such as the possible use of a skilled nursing facility or its equivalent prior to formal hospitalization of ACSC cases, particularly in rural areas. Further research would examine whether the actual ACSC hospitalization rate is correlated with self-reported propensity to hospitalize when non-medical factors come into play. Acknowledgements Funding and technical assistance is gratefully acknowledged from the Health Research Center, Department of Family and Preventive Medicine, University of Utah School of Medicine. The authors thank Louise Nieto, Ronald Lewis, Becky Edwards, and Karen Orlando for their contributions to this paper. 24 |
