Younger People Travel to Urban Hospitals for Care

In 2010, 6.1 million people who lived in rural areas were hospitalized, and of that number 60 percent sought care at hospitals in rural areas and 40 percent traveled to urban areas for hospital services, according a new report from the Centers of Disease Control and Prevention (CDC). The report, Rural Residents Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010, examined the differences in who sought care in urban areas as opposed to rural areas, what type of care was provided by hospitals in both regions to rural residents, and what type of care settings rural residents were discharged to by urban and rural hospitals. Interestingly, the death rate of rural residents admitted to a hospital in an urban area was the same as a rural resident admitted to hospital in a rural area; 2 percent.

Travel for Care

Elderly rural residents seek care in rural areas, according to the CDC’s report. Roughly 51 percent of rural residents 65 years or older who were hospitalized in 2010 were hospitalized in a rural hospital. A majority of rural residents who were hospitalized in 2010 and were 64 years of age or younger were hospitalized in an urban hospital. The CDC stated that prior research showed that older patients (patients over 65 years of age) were less likely to travelfor hospital services due, in part, to barriers imposed by traveling to urban areas and a preference to remain closer to their homes.

Service Received

A little more than one-third, 38 percent, of rural residents hospitalized in a rural hospital received surgical or nonsurgical procedure during their stay. Rural residents hospitalized in urban hospitals received far more surgical and non-surgical services. Seventy-four percent of rural residents in an urban hospital received a surgical or nonsurgical procedure, and rural residents in urban hospitals were three times as more likely to receive three or more procedures than rural residents in rural hospitals. The CDC referred to a study that showed that due to economies of scale and volume of patients, many rural hospitals do not offer many types of diagnostic tests or specialized treatments.

Discharges

Rural residents in rural hospitals were less likely to be discharged to their home and more likely to be discharged to another short-term hospital or to a long-term care institution. Only 63 percent of rural residents receiving care a rural hospital were discharged to their home while 81 percent of rural residents in urban hospitals were discharged to their home. Only 3 percent of rural residents in an urban hospital were transferred to another short-term hospital while 7 percent of rural residents in a rural hospital were transferred to another short-term hospital. Repeating the pattern, 14 percent of rural residents who received services from a hospital in a rural area were discharged to a long-term care institution, while only 8 percent of rural residents who received care in an urban hospital were discharged to a long-term care institution.

Earlier Study

The CDC used data from the National Hospital Discharge Survey, which has been conducted annually from 1965 through 2010, for this study. An earlier study by the CDC using the same data showed that overall only 12 percent of the 35 million hospitalization in the U.S. in 2010 were in rural hospitals (see Rural hospitals serve fewer patients, perform fewer services that urban counterparts, reported on April 24, 2014). The earlier report found that the percentage of rural hospitalizations was not only slightly less than the overall rural population, which in 2010 was 17 percent of the country. Data from that study also determined that fewer services were performed in rural hospitals, with only 6 percent of the 51 million inpatient medical procedures performed in 2010 occurring in rural hospitals.