Death rates for heart and pneumonia patients at critical-access hospitals are rising nationally, study finds

Death rates are rising at rural critical-access hospitals for Medicare patients who have heart attacks, heart failure and pneumonia, according to a study published in the Journal of the American Medical Association.

Hospitals designated as critical-access get slightly higher Medicsare and Medicaid reimbursements in exchange for limiting their size, procedures and patient stays. In 2002, they had a death rate of 12.8 percent for such ailments, under the 13 percent rate at other hospitals. But from
2002 to 2010, mortality rates at critical-access hospitals increased 0.1 percent each year, to 13.3 percent, while the rates at other hospitals fell 0.2 percent each year, to 11.4 percent.

There are 1,331 hospitals in the critical access program, Jordan Rau reports for USA Today. “Congress started the critical access program in 1997 to stave off
hospital closures in places where patients had no good alternative
because the next hospital was at least 35 miles away by regular roads or
15 miles by secondary roads. To qualify hospitals need 25 or fewer beds.”
 
The authors of the study “suggested that the hospitals’ care may suffer because they don’t have
the latest sophisticated technology or specialists to treat the
increasingly elderly and frail rural populations,” Rau reports. “Since hospitals are not required to submit performance evaluations
to Medicare, the government may not realize that facilities could need
additional assistance in caring for sicker patients.”

Brock Slabach of the National Rural Health Association told Rau that the statistics don’t always tell the complete story and that “The association’s own research has found that
rural hospitals do better in patient satisfaction surveys than do urban
hospitals,” Rau writes.