JAMA study: Isolated, rural hospitals have poorer quality

Despite efforts tying quality of care to provider reimbursements, a study published in today's issue of the Journal of the American Medical Association found that critical access hospitals (CAHs) in rural areas have fewer clinical capabilities, lower quality of care, and worse patient outcomes compared with other hospitals. Researchers found that patients admitted to CAHs (geographically isolated facilities with no more than 25 acute care beds) for heart attack, congestive heart failure, or pneumonia had a 30 to 70 percent higher risk of dying within 30 days than those at other hospitals. "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 lead author Karen Joynt, a research fellow in Harvard School of Public Health's Department of Health Policy and Management. Press Release