(dailyRx)
Patients at smaller, rural hospitals may not be getting the same quality of care as some of the larger hospitals inside major cities. A study indicates patients at these less accessible hospitals have a greater chance of dying from serious illnesses such as congestive heart failure.
Harvard School of Public Health researchers said the study marked the first national study to examine care at critical access hospitals in rural areas. It revealed that such facilities have fewer clinical capabilities, lower quality of care and worse patient outcomes.
The study revealed that patients admitted at such facilities had 30 to 70 percent higher odds of dying within 30 days after being admitted for heart attack, congestive heart failure or pneumonia.
The government defines critical access hospitals as geographically isolated facilities with fewer than 25 acute care beds. About 25 percent of U.S. hospitals have received that designation from the Medicare Rural Hospital Flexibility Program of the 1997 Balanced Budget Act. The program, which included payment reform, was created to ensure access to care for those that live in rural areas.
Ashish Jha, senior author on the study and an associate professor in HSPH’s department of health policy and management, said she was surprised at the findings, and that the results of the study indicate a need to offer additional aid in helping these hospitals to improve.
Researchers analyzed the records of 2.5 million Medicare fee-for-service beneficiaries at 4,738 hospitals, diagnosed with heart attack, congestive heart failure, and pneumonia between 2008 and 2009.
Compared with other hospitals, critical access hospitals were less likely to have intensive care facilities, advanced cardiac care capabilities, or even basic electronic health records. About a quarter of the hospitals examined were critical access hospitals.
The findings were published in the Journal of the American Medical Association.
Coronary Artery Disease
Coronary artery disease is the leading cause of death in the United States and in the rest of the world. Estimates point to almost one half of all middle aged men and one third of all middle aged women in the United States developing some form of CAD. The primary symptom of angina, commonly known as chest pain, occurs when the artery is almost completely blocked.
Plaques made up of cholesterol and fibrous tissue lodge in the walls of the arteries that supply blood to the heart. Slow growth of the plaques can cause chest pain as they restrict blood flow to the heart muscle, and complete closure or rupture of the plaque can cause a myocardial infarction, commonly known as a heart attack, with resulting disability or death. CAD is primarily a disease of diet and habits, with the greatest risk factors coming from smoking, high blood pressure, high cholesterol, and diabetes.