Critical Access Hospitals in Rural Areas Lag in Care Quality, Study Says
Critical access hospitals serving rural communities had higher mortality rates and provided lower quality care than non-critical access hospitals, according to a study published in the Journal of the American Medical Association, Modern Healthcare reports (Barr, Modern Healthcare, 7/5).
For the study, Harvard School of Public Health researchers analyzed 2008-2009 data from Medicare, the American Hospital Association and the Hospital Quality Alliance for 4,800 hospitals.
About 1,268 facilities were designated as critical access facilities. These hospitals had a maximum of 25 acute care beds and were located more than 35 miles from the nearest full-service hospital.
The study found a higher 30-day mortality rate for critical access hospitals than for non-critical access hospitals for patients with acute myocardial infarction, congestive heart failure and pneumonia.
Respectively, the mortality rates for critical access hospitals and non-critical access facilities were:
- 23.5% and 16.2% for acute myocardial infarction;
- 13.4% and 10.9% for heart failure; and
- 14.1% and 12.1% for pneumonia.
Researchers also found that critical access facilities were less likely to have basic electronic health records, cardiac catheterization capabilities and intensive care units (Preidt, HealthDay, 7/5).
According to the study's authors, although accepting Medicare patients has improved the financial health of critical access facilities, the findings suggest that efforts to improve access to care "have been insufficient in ensuring high-quality care" (Modern Healthcare, 7/5).
They wrote that the findings highlight a need for more focused efforts to improve care quality at rural facilities "so that all individuals in the United States have access to high-quality inpatient care regardless of where they live" (HealthDay, 7/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.