Dive Brief:
- A report published Tuesday in JAMA shows patients undergoing common surgical procedures at critical access hospitals--the main source of care in rural areas--may fare better than patients at major urban non–critical access hospitals, and cost less to boot.
- The researchers reviewed outcomes for 1.6 million Medicare beneficiary admissions for appendectomy, cholecystectomy, colectomy, and hernia repair at both types of hospitals between 2009 and 2013.
- Medicare's cost for surgeries at critical access hospitals was almost $1,400 less on average than for surgeries at major centers, at $14, 450 compared with. $15, 845.
Dive Insight:
The study concludes that overall, patients undergoing procedures at critical access hospitals had no significant difference in 30-day mortality rates, had decreased risk-adjusted serious complication rates, and had lower-adjusted Medicare expenditures.
These patients had a mean age of 76.5 years, were 56.2% female, were less likely to have chronic medical issues, and had lower rates of heart failure, diabetes, obesity or multiple comorbid diseases.
The researchers adjusted for patient factors in finding critical access and non–critical access hospitals to have no statistically significant differences in their 30-day mortality rates, and found critical access hospitals to have had significantly lower rates of serious complications (6.4% vs. 13.9%).
The lower Medicare expenditures at critical access hospitals were also adjusted for patient factors and procedure type.
"From a surgical standpoint, these hospitals appear to be doing exactly what we would want them to be doing: common operations on appropriately selected patients who are safe to stay locally for their care," study co-author Andrew Ibrahim, a surgeon at the critical access McPherson Hospital in McPherson, said in a prepared statement.