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Rural Hospital Mortality Rates Climbed From 2002-2010

Rural Hospital Mortality Rates Climbed From 2002-2010

Findings look at Medicare beneficiaries treated for heart attack, heart failure, and pneumonia

WEDNESDAY, April 3 (HealthDay News) -- Thirty-day mortality rates for patients admitted to critical access hospitals (CAHs; designated hospitals for individuals living in rural communities) increased from 2002 to 2010 compared with patients admitted to other acute care hospitals, according to a study published online April 2 in the Journal of the American Medical Association.

Karen E. Joynt, M.D., from the Harvard School of Public Health in Boston, and colleagues used Medicare fee-for-service data to identify patients admitted to U.S. acute care hospitals with acute myocardial infarction (1,902,586 admissions), congestive heart failure (4,488,269 admissions), and pneumonia (3,891,074 admissions) between 2002 and 2010.

The researchers found that CAHs had mortality rates comparable with those of non-CAHs in 2002 (composite mortality across all 3 conditions, 12.8 percent versus 13.0 percent), when controlling for differences in patient, hospital, and community characteristics. Between 2002 and 2010, there was a 0.3 percent change in the annual difference in mortality rates with a 0.1 percent increase in mortality in CAHs and a 0.2 percent decrease per year in non-CAHs. By 2010, mortality rates were significantly higher at CAHs compared with non-CAHs (13.3 percent versus 11.4 percent). When each condition was analyzed separately, the patterns were similar. Similar patterns were also seen when comparing CAHs with other small, rural hospitals.

"Among Medicare beneficiaries with acute myocardial infarction, congestive heart failure, or pneumonia, 30-day mortality rates for those admitted to CAHs, compared with those admitted to other acute care hospitals, increased from 2002 to 2010," the authors write.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1674237 )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1674237 )Editorial (http://jama.jamanetwork.com/article.aspx?articleid=1674216 )