Ross Joseph S, Normand Sharon-Lise T, Wang Yun, Nallamothu Brahmajee K, Lichtman Judith H, Krumholz Harlan M
Mt. Sinai School of Medicine, New York City, USA.
Health Aff (Millwood). 2008 Nov-Dec;27(6):1707-17. doi: 10.1377/hlthaff.27.6.1707.
Rural U.S. communities face major challenges in ensuring the availability of high-quality health care. We examined whether hospital-specific, all-cause, thirty-day risk-standardized mortality rates (RSMRs) following acute myocardial infarction, heart failure, and pneumonia varied by hospitals' geographic remoteness. We analyzed 2001-2003 Medicare administrative data, comparing RSMRs among hospitals located in urban, large rural, small rural, or remote small rural regions. We found only small mortality differences across remoteness regions for hospitalizations for the three conditions. We examine the implications of these findings for the millions of Americans who rely upon rural hospitals for their care.
美国农村社区在确保高质量医疗保健的可及性上面临重大挑战。我们研究了急性心肌梗死、心力衰竭和肺炎后特定医院的全因30天风险标准化死亡率（RSMRs）是否因医院的地理偏远程度而异。我们分析了2001 - 2003年医疗保险管理数据，比较了位于城市、大农村、小农村或偏远小农村地区医院之间的RSMRs。我们发现，对于这三种疾病的住院治疗，偏远地区之间的死亡率差异很小。我们探讨了这些发现对数百万依赖农村医院提供医疗服务的美国人的影响。
