HealthDay News — Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.
Kenton J. Johnston, Ph.D., from St. Louis University, and colleagues examined a nationally representative survey of Medicare beneficiaries with one or more complex chronic conditions representing 61 and 57 percent of rural and urban Medicare beneficiaries, respectively.
The researchers found that compared with urban residence, rural residence correlated with a 40 percent higher preventable hospitalization rate and a 23 percent higher mortality rate. After adjustment for having one or more primary care provider visits, having one or more specialist visits during the previous year correlated with a 15.9 and 16.6 percent lower preventable hospitalization rate and lower mortality rate, respectively, for individuals with chronic conditions. Overall, 55 and 40 percent of the rural-urban differences in preventable hospitalizations and mortality, respectively, were accounted for by access to specialists.
“We found that access to care, particularly to specialists, explained a sizable portion of the difference in preventable hospitalization and mortality rates between rural and urban beneficiaries,” the authors write.