Monday, May 23, 2016

Maybe your small town hospital is just fine

A new look-see shows that critical care hospitals in small towns may be superior for some operations--which is good because these are the hospitals closest to 20% of Americans.

The team, led by Univ of Michigan researchers, analzyed data from 1.6 million hospital stays for four operations: gallbladder removal, colon surgery, hernia repairs, and appendectomy.

In this sample:

--The risk of dying within 30 days of the operation were the same in small town hospitals and larger hospitals

--The risk of a complication (heart attack, pneumonia or kidney damage) was lower at critical access hospitals in rural areas

--Patients who had surgery at those hospitals cost Medicare an average of $1,400 less

--The patients in these small town areas were healthier going to surgery, which suggests surgeons may send sicker patients to larger hospitals

--But even after correcting for difference in pre-op health, outcomes were equal to or better than in larger hospitals

--Fewer than 5% of those in small town hospitals got transferred to larger hospitals--this was 25% for non-surgical patients

--Patients in critical care hospitals were less likely to need a skilled nursing facility after leaving the hospital

Hundreds of critical access hospitals are in danger of closing. Medicare pays them slightly more to keep them open and available to people in rural areas.

One researcher remarked that these hospitals are doing what they are supposed to. They are performing common operations in appropriately selected patients who are OK to get their care nearby.

Where we go from here could affect you.

No comments: