Narrowing performance gap between rural and urban hospitals for acute myocardial infarction care

Rural communities experience significant barriers to quality healthcare, including disparities in medical care following acute myocardial infarctions (AMI). This study sought to determine if the population density of the county where Medicare patients were hospitalized following AMI predicted short-...

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Bibliographic Details
Published in:The American journal of emergency medicine 2020-01, Vol.38 (1), p.89-94
Main Authors: Alghanem, Fares, Clements, John M.
Format: Article
Language:English
Subjects:
Acute
Aged
Angioplasty
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Aspirin
Aspirin - therapeutic use
Classification
Classification schemes
Data analysis
Digital archives
Electrocardiography
Emergency medical care
Female
Generalized linear models
Health care
Health care policy
Healthcare Disparities
Heart attacks
Hospital costs
Hospital Mortality
Hospitals
Hospitals, Rural - standards
Hospitals, Urban - standards
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Infarction
Male
Medicare
Mortality
Myocardial
Myocardial infarction
Myocardial Infarction - therapy
Outcomes
Patient Readmission - statistics & numerical data
Patients
Percutaneous Coronary Intervention
Population Density
Quality
Quality Indicators, Health Care
Rural
Rural areas
Rural health care
Time-to-Treatment
United States
Urban health care
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Summary:Rural communities experience significant barriers to quality healthcare, including disparities in medical care following acute myocardial infarctions (AMI). This study sought to determine if the population density of the county where Medicare patients were hospitalized following AMI predicted short-term outcomes and to quantify longitudinal changes in hospital performance on quality of care metrics. Hospital-level data was queried from the 2012 and 2018 Centers for Medicare & Medicaid Services archives. Each hospital was classified based on residing county using the National Center for Health Statistics Rural-Urban Continuum Codes (RUCC). Variations and longitudinal changes in risk-adjusted outcomes and quality of care metrics were stratified by RUCC classification and analyzed. Among the 4798 hospitals identified, rural hospitals had significantly higher risk-adjusted 30-day mortality (rs = 0.095, p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2019.04.030