Featured Research

from universities, journals, and other organizations

Critical access hospitals have higher transfer rates after surgery

Date:
May 14, 2014
Source:
The JAMA Network Journals
Summary:
Hospital transfers happened more often after surgery at critical access hospitals (CAHs) but the proportion of patients using post-acute care was equal to or less than that of patients treated at non-CAHs. The CAH designation was created to provide financial support to rural hospitals. As such, they are exempt from Medicare's Prospective Payment System and instead are paid cost-based reimbursement. The proliferation of CAHs after the payment policy change has increased interest in the quality and cost of care these facilities provide.

Hospital transfers happened more often after surgery at critical access hospitals (CAHs) but the proportion of patients using post-acute care was equal to or less than that of patients treated at non-CAHs.

Related Articles


The CAH designation was created to provide financial support to rural hospitals. As such, they are exempt from Medicare's Prospective Payment System and instead are paid cost-based reimbursement. The proliferation of CAHs after the payment policy change has increased interest in the quality and cost of care these facilities provide.

The authors used data from the Nationwide Inpatient Sample and the American Hospital Association to examine patients undergoing six common surgical procedures (hip and knee replacement, hip fracture repair, colorectal cancer resection, gall bladder removal and transurethral resection of the prostate [TURP]) at CAHs or non-CAHs. The authors measured hospital transfer, discharge with post-acute care or routine discharge. The authors identified 4,895 acute-care hospitals reporting from 2005 through 2009: 1,283 (26.2 percent) of which had a CAH designation.

For each of the six inpatient surgical procedures, a greater proportion of patients from CAHs were transferred to another hospital (after adjustment for patient and hospital factors), ranging from 0.8 percent for TURP to 4.1 percent for hip fracture repair for CAH patients and from with 0.2 percent and 1.2 percent for the same procedures, respectively, for non-CAH patients. However, patients discharged from CAHs were less likely to receive post-acute care for all but one of the procedures (TURP) examined. The likelihood of receiving post-acute care ranged from 7.9 percent for gall bladder removal to 81.2 percent for hip fracture repair for CAH patients and from 10.4 percent to 84.9 percent, respectively, for non-CAH patients. The authors note there must be future work to define the causes for the disparity in transfer rates.

"These results will affect the ongoing deliberations concerning CAH payment policy and its implications for health care delivery in rural communities."

Commentary: The Right Triangle

In a related commentary, Matthew J. Resnick, M.D., and Daniel A. Barocas, M.D., M.P.H., of Vanderbilt University, Nashville, Tenn., write: "The article by Gadzinski and colleagues raises important questions about how best to maintain access to surgical care in underserved communities."

"There remains no obvious mechanism to ensure the financial viability of individual CAHs, particularly in the era of the integrated health care delivery system. Medicare will probably have to continue subsidizing these hospitals to maintain broad access to financially unsuccessful service lines; the challenge will be to keep the quality and cost corners of the triangle from growing too obtuse or acute."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Adam J. Gadzinski, Justin B. Dimick, Zaojun Ye, John L. Zeller, David C. Miller. Transfer Rates and Use of Post–Acute Care After Surgery At Critical Access vs Non–Critical Access Hospitals. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2013.5694
  2. Matthew J. Resnick, Daniel A. Barocas. The Right Triangle. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2013.5707

Cite This Page:

The JAMA Network Journals. "Critical access hospitals have higher transfer rates after surgery." ScienceDaily. ScienceDaily, 14 May 2014. <www.sciencedaily.com/releases/2014/05/140514165412.htm>.
The JAMA Network Journals. (2014, May 14). Critical access hospitals have higher transfer rates after surgery. ScienceDaily. Retrieved March 28, 2015 from www.sciencedaily.com/releases/2014/05/140514165412.htm
The JAMA Network Journals. "Critical access hospitals have higher transfer rates after surgery." ScienceDaily. www.sciencedaily.com/releases/2014/05/140514165412.htm (accessed March 28, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, March 28, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com
These Popular Antibiotics Can Cause Permanent Nerve Damage

These Popular Antibiotics Can Cause Permanent Nerve Damage

Newsy (Mar. 27, 2015) — A popular class of antibiotic can leave patients in severe pain and even result in permanent nerve damage. Video provided by Newsy
Powered by NewsLook.com
WH Plan to Fight Antibiotic-Resistant Germs

WH Plan to Fight Antibiotic-Resistant Germs

AP (Mar. 27, 2015) — The White House on Friday announced a five-year plan to fight the threat posed by antibiotic-resistant bacteria amid fears that once-treatable germs could become deadly. (March 27) Video provided by AP
Powered by NewsLook.com
House Ready to Pass Medicare Doc Bill

House Ready to Pass Medicare Doc Bill

AP (Mar. 26, 2015) — In rare bipartisan harmony, congressional leaders pushed a $214 billion bill permanently blocking physician Medicare cuts toward House passage Thursday, moving lawmakers closer to resolving a problem that has plagued them for years. (March 26) Video provided by AP
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