Death rates on the rise at some rural hospitals

A new study finds that these critical access hospitals, which are exempt from reporting certain quality and outcomes data to the federal government, are not matching the gains made by other facilities regarding mortality rates after treatment for heart attacks, heart failure and pneumonia.  

Kaiser Health News: Death Rates Rise At Geographically Isolated Hospitals, Study Finds
For 15 years, Congress has bestowed special privileges to some small remote hospitals, usually in rural areas, to help them stay afloat. Medicare pays them more than it pays most hospitals and exempts them from financial pressure to operate efficiently and requirements to reveal how their patients fare. Nearly one in four hospitals qualifies for the program. Despite these benefits, there's new evidence that the quality of many of these hospitals may be deteriorating. A study published Tuesday found that during the past decade the death rates of patients at these critical access hospitals were growing while mortality rates at other hospitals were dropping (Rau, 4/2).

Reuters: Small, Rural Hospitals Lag On Some Quality Measures
Although fewer people are dying shortly after treatment for heart attacks, heart failure and pneumonia at most U.S. hospitals than a decade ago, the same trend doesn't apply to certain small, rural facilities, a new study suggests. So-called critical access hospitals -- which have no more than 25 beds and are typically miles from the nearest other hospital -- are exempt from reporting those sort of quality and outcomes data to the government (Pittman, 4/2).

Medpage Today: Mortality Worse At Critical Access Hospitals
After controlling for patient, hospital, and community factors, Medicare data on 30-day mortality rates for three major conditions at critical access hospitals showed an average annual 0.1 percent increase during the 9-year study period versus an annual decrease averaging 0.2 percent in other hospitals, reported Karen Joynt, MD, MPH, of the Harvard School of Public Health, and colleagues. The three conditions were acute myocardial infarction (MI), congestive heart failure, and pneumonia. At the 2002 baseline year, 30-day mortality rates in critical access and other hospitals for Medicare patients with these diagnoses were nearly the same -- 12.8 percent versus 13 percent after adjustments, respectively, the researchers noted in their report, appearing in the April 3 issue of the Journal of the American Medical Association (Gever, 4/2).