Mortality rates of Medicare patients in critical access hospitals rose between 2002 and 2010 while dropping at other hospitals, according to a study published in the Journal of the American Medical Association.
Death rates at other hospitals dropped by 0.2 percent a year to 11.4 percent in 2010, but mortality rates at critical access hospitals (CAHs) rose 0.1 percent each year to 13.3 percent in 2010, according to the study.
CAHs are at risk of falling behind in quality improvement due to limited resources and vulnerable patients. The study aimed to evaluate trends in mortality for patients receiving care at CAHs, compared with patients receiving care at non-CAHs. Researchers looked at patients hospitalized for acute myocardial infarction, congestive heart failure and pneumonia.
"This carved-out group of hospitals seems to be falling further and further behind," lead author Karen Joynt, M.D., of the Harvard School of Public Health told Kaiser Health News. "As we have more advanced treatments, it's harder for rural hospitals to keep up."
Joynt also suggested certain CAHs may be "victims of their lenient treatment by the government." Hospital officials aren't required to evaluate performance in reports to Medicare, so the government might not know they need extra assistance. Joynt called these hospitals "invisible."
Brock Slabach of the National Rural Health Association cautioned against making sweeping conclusions from the report, Kaiser Health News reported.
Meanwhile, Sens. Jerry Moran (R-Kan.) and Amy Klobuchar (D-Minn.) threw their support behind rural hospitals in February, calling them "essential to the survival and success of communities" despite potential cuts to Medicare.
The critical access hospital program began in 1997 to address rural hospital closures. Hospitals with 25 beds or less located 35 miles from the closest inpatient facility could qualify for reimbursements of 101 percent of cost, while being excused from participating in national quality-improvement initiatives, MedPageToday reported. The JAMA study concludes new efforts might be required to help critical access hospitals.
To learn more:
- read the JAMA study abstract
- read the Kaiser Health News report
- read the MedPage Today article
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