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Utilization and outcomes of inpatient surgical care at critical access hospitals in the United States.


ABSTRACT: There is a growing interest in the quality and cost of care provided at Critical Access Hospitals (CAHs), a predominant source of care for many rural populations in the United States.To evaluate utilization, outcomes, and costs of inpatient surgery performed at CAHs.A retrospective cohort study of patients undergoing inpatient surgery from 2005 through 2009 at CAHs or non-CAHs was performed using data from the Nationwide Inpatient Sample and American Hospital Association.The CAH status of the admitting hospital.In-hospital mortality, prolonged length of stay, and total hospital costs.Among the 1283 CAHs and 3612 non-CAHs reporting to the American Hospital Association, 34.8% and 36.4%, respectively, had at least 1 year of data in the Nationwide Inpatient Sample. General surgical, gynecologic, and orthopedic procedures composed 95.8% of inpatient cases at CAHs vs 77.3% at non-CAHs (P??.05 for all), with the exception that Medicare beneficiaries undergoing hip fracture repair in CAHs had a higher risk of in-hospital death (adjusted odds ratio?=?1.37; 95% CI, 1.01-1.87). However, despite shorter hospital stays (P???.001 for 4 procedures), costs at CAHs were 9.9% to 30.1% higher (P?

SUBMITTER: Gadzinski AJ 

PROVIDER: S-EPMC3918670 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Utilization and outcomes of inpatient surgical care at critical access hospitals in the United States.

Gadzinski Adam J AJ   Dimick Justin B JB   Ye Zaojun Z   Miller David C DC  

JAMA surgery 20130701 7


<h4>Importance</h4>There is a growing interest in the quality and cost of care provided at Critical Access Hospitals (CAHs), a predominant source of care for many rural populations in the United States.<h4>Objective</h4>To evaluate utilization, outcomes, and costs of inpatient surgery performed at CAHs.<h4>Design, setting, and patients</h4>A retrospective cohort study of patients undergoing inpatient surgery from 2005 through 2009 at CAHs or non-CAHs was performed using data from the Nationwide  ...[more]

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