Featured Research

from universities, journals, and other organizations

Patients at small, isolated, rural hospitals in US more likely to receive lower quality of care

Date:
July 5, 2011
Source:
Harvard School of Public Health
Summary:
In the first national study to examine care at critical access hospitals (CAHs) in rural areas of the US, researchers found that CAHs have fewer clinical capabilities, lower quality of care, and worse patient outcomes compared with other hospitals.

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.

Related Articles


"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."

Study authors included Yael Harris, director of the Office of Health IT & Quality at the U.S. Department of Health and Human Services and E. John Orav, associate professor in the Department of Biostatistics at HSPH.


Story Source:

The above story is based on materials provided by Harvard School of Public Health. Note: Materials may be edited for content and length.


Journal References:

  1. K. E. Joynt, Y. Harris, E. J. Orav, A. K. Jha. Quality of Care and Patient Outcomes in Critical Access Rural Hospitals. JAMA: The Journal of the American Medical Association, 2011; 306 (1): 45 DOI: 10.1001/jama.2011.902
  2. M. S. Lipsky, M. Glasser. Critical Access Hospitals and the Challenges to Quality Care. JAMA: The Journal of the American Medical Association, 2011; 306 (1): 96 DOI: 10.1001/jama.2011.928

Cite This Page:

Harvard School of Public Health. "Patients at small, isolated, rural hospitals in US more likely to receive lower quality of care." ScienceDaily. ScienceDaily, 5 July 2011. <www.sciencedaily.com/releases/2011/07/110705183628.htm>.
Harvard School of Public Health. (2011, July 5). Patients at small, isolated, rural hospitals in US more likely to receive lower quality of care. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2011/07/110705183628.htm
Harvard School of Public Health. "Patients at small, isolated, rural hospitals in US more likely to receive lower quality of care." ScienceDaily. www.sciencedaily.com/releases/2011/07/110705183628.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins