Navigation Links
Patients at small, isolated, rural hospitals in US more likely to receive lower quality of care
Date:7/5/2011

Boston, MA In the first national study to examine care at critical access hospitals (CAHs) in rural areas of the U.S., Harvard School of Public Health (HSPH) researchers found that CAHs have fewer clinical capabilities, lower quality of care, and worse patient outcomes compared with other hospitals. The researchers found that patients admitted to a CAH for heart attack, congestive heart failure, or pneumonia were at greater risk of dying within 30 days than those at other hospitals. The study shows that despite more than a decade of policy efforts to improve rural health care, substantial challenges remain.

"Critical access hospitals face a unique set of obstacles to providing high quality care, and our findings suggest that their needs are not being met by current health policy efforts," said Karen Joynt, a research fellow in HSPH's Department of Health Policy and Management and the lead author of the paper.

The study appears in the July 6, 2011, Journal of the American Medical Association (JAMA).

The government defines CAHs as geographically isolated facilities with no more than 25 acute care beds. More than a quarter of acute care hospitals in the United States have been designated CAHs by the Medicare Rural Hospital Flexibility Program of the 1997 Balanced Budget Act. The program created payment reform that has kept small rural hospitals financially solvent, preserving access to care for rural Americans who might otherwise have no accessible inpatient provider.

Joynt and her colleagues analyzed the records of 2,351,701 Medicare fee-for-service beneficiaries at 4,738 hospitals (26.8 percent of which were CAHs) diagnosed with acute myocardial infarction (heart attack), congestive heart failure, and pneumonia in 2008-2009. Compared with other hospitals, CAHs were less likely to have intensive care facilities, advanced cardiac care capabilities, or even basic electronic health records. These hospitals were less likely to provide appropriate evidence-based care, as measured by the Hospital Quality Alliance metrics.

Patients admitted to CAHs had 30 to 70 percent higher odds of dying within 30 days after being admitted for heart attack, congestive heart failure or pneumonia. "We were surprised at the magnitude of these findings," said Ashish Jha, senior author on the study and an associate professor in HSPH's Department of Health Policy and Management. "These findings suggest that we need to redouble our efforts to help these hospitals improve."

"To improve the quality of care patients receive at CAHs, policy makers could explore partnerships with larger hospitals, increasing use of telemedicine, or inclusion of these hospitals in national quality improvement efforts," said Joynt. "Helping these hospitals improve is essential to ensuring that all Americans receive high-quality care, regardless of where they live."


'/>"/>

Contact: Marge Dwyer
mhdwyer@hsph.harvard.edu
617-432-8416
Harvard School of Public Health
Source:Eurekalert

Related medicine news :

1. ALK rearrangement found in nearly 10 percent of patients in Lung Cancer Mutation Consortium
2. Worse outcomes for older breast cancer patients with other health problems
3. Heart transplant patients at risk for serious skin cancers
4. Delaying Intravenous Feeding of ICU Patients May Aid Recovery
5. Research Sheds Light on Cause of Brain Deficits in HIV Patients
6. Patients treated with sunitinib and sorafenib respond to flu vaccine
7. Innovative UBC-BC Cancer Agency system reduces waitlisting for chemotherapy patients
8. Team approach reduces urinary tract infections in rehab patients
9. Intensive, hands-on effort reduces bloodstream infections in critically ill patients
10. Surprising drop in physicians willingness to accept patients with insurance
11. Nearly Half of Older Breast Cancer Patients Dont Get Radiation
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/31/2016)... ... 2016 , ... Psoriasis: Targets and Therapy has ... corresponding author Professor Luigi Naldi says “The review in Psoriasis: Targets and Therapy ... the onset and the severity of psoriasis, and negatively influences the response to ...
(Date:5/31/2016)... ... May 31, 2016 , ... Throughout the day, adults often find themselves reaching for ... awareness, but what they could be reaching for instead is a cup of Matcha green ... grown in Japan. This sacred tea is harvested from early June to mid-July, when the ...
(Date:5/31/2016)... Jose, CA (PRWEB) , ... May 31, 2016 , ... ... , announces its strategic partnership with e-Jan Networks Co., the leading provider of ... enterprises are customers of e-Jan Networks’s leading CACHATTO remote access solution. ...
(Date:5/31/2016)... ... May 31, 2016 , ... ... of advanced Artificial Intelligence (AI) and the latest in Clinical Patient Pod ... is integrating predictive analytic outputs directly into the clinical workflow. These insights are ...
(Date:5/31/2016)... (PRWEB) , ... May 31, 2016 , ... ... attribute calls back to particular advertising campaigns, to monitor the performance of sales ... they can maximize conversions and revenue. The software allows customers to record, transcribe, ...
Breaking Medicine News(10 mins):
(Date:5/31/2016)... , May 31, 2016 The ... is progressing at a CAGR of 10.6% within a ... valued at US$0.46 bn in 2013. Owing to favorable ... to reach US$0.88 bn by the end of this ... from the market,s holistic representation in a research report ...
(Date:5/31/2016)... 2016 The global biomaterials market is ... prevalence of deaths from chronic diseases. According to research report, ... Country): Opportunities and Forecasts (2016-2021) - (By Value; By Material ... Surgery, Wound Care); By Region-North America, Europe ... Germany , Italy , ...
(Date:5/31/2016)... May 31, 2016 RnRMarketResearch.com adds ... with comparative analysis of Asthma therapy at various stages, ... route of administration (RoA) and molecule type, along with ... also reviews key players involved in the therapeutic development ... projects. Complete report on H1 2016 pipeline ...
Breaking Medicine Technology: