Hospitalized rural Medicare patients less likely to receive follow-up care, more likely to end up in ER

Rural Medicare patients are less likely than urban patients to receive follow-up care after leaving the hospital and more likely to end up in an emergency room or be re-hospitalized, says a study by researchers at RTI International and the University of North Carolina-Chapel Hill published in the September issue of the journal Medical Care. Researchers found that "patients living in isolated areas were 19 percent less likely to receive follow-up care within 30 days after leaving the hospital than those in urban areas."

Researchers used the Medicare Current Beneficiary Survey to look at 12,000 Medicare-eligible patients with hospital admissions between 2000 and 2010. They looked at the number of patients who had follow-up health care visits, emergency department visits and unplanned hospital re-admissions during the first 30 days after hospitalization.

The study found that rural patients are more likely than urban ones to visit an emergency room, with the risk of visiting an emergency room 52 percent higher for rural patients in a larger setting and 44 percent higher for rural patients in a smaller setting.

While the overall re-admission rate was similar for rural and urban residents, the "difference became significant when patients were classified by the location of the hospital where they were treated, rather than where they lived. Thirty-day readmission risk was 32 percent higher for patients discharged from hospitals in large rural settings and 42 percent higher for hospitals in small rural settings, compared to urban settings." The study did not give a reason why more rural residents fail to receive follow-up care, though other studies have said transportation is one of the main issues. (Read more)