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Mortality Rates at CAHs Ratcheting Higher

John Commins, for HealthLeaders Media, April 3, 2013

The nation's critical access hospitals have higher mortality rates on several key measures than do urban and rural hospitals without the specia l designation, and the trend steadily worsened over the past eight years, according to a new study by Harvard researchers.

The study was published this week in the Journal of the American Medical Association.

Researchers from Harvard Medical School and the Harvard School of Public Health examined administrative data from nearly 10 million Medicare fee-for-service admissions for acute myocardial infarction, congestive heart failure, and pneumonia between 2002–2010.

The researchers compared 30-day mortality rates of CAHs and non-CAHs in urban and rural settings. They found that while CAHs and non-CAHs had comparable mortality rates for the three conditions in 2002, CAHs gradually fell behind each year to the point where by 2010 CAHs mortality rates were 13.3% and non-CAH mortality rates were 11.4%, a difference of 1.8%.

"What it is telling us is that we have left these hospitals behind because 1.8% of the absolute mortality rate is one in 50 people. That is more than 10% of the actual rate so in clinical trial speak it is a significant relevant risk," Karen E. Joynt, MD, lead researcher of the study, said in an interview.

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