Determinants of hospital utilization and surgery on the Navajo Indian reservation: 1972–1978

Hospital data from the Navajo Reservation indicate that utilization has been responsive to changes in the health care system, Navajo social organization, and disease patterns. Distance of a community from the nearest hospital is the best predictor of hospitalization rates in the community but involvement in the wage economy and household size also enter significantly into the regression. Age of patients is also significantly related to distance as well as to age of the population and to dependence upon welfare. The rate of cholecystectomies in a community is best explained by distance from the nearest hospital offering surgery. This is in contrast to rates of appendectomies and hysterectomies, which appear to be most significantly related to measures of acculturation to the dominant society.