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Rural Intermediate Care Hospitalizations Tied to Worse Outcomes

Adjusted 30-day mortality significantly higher than urban intermediate care hospitalizations

By Lori Solomon HealthDay Reporter

THURSDAY, Feb. 8, 2024 (HealthDay News) — Hospitalization in rural intermediate care is associated with increased mortality, according to a study published online Jan. 19 in the Annals of the American Thoracic Society.

Emily A. Harlan, M.D., from the University of Michigan in Ann Arbor, and colleagues examined relationships of rurality and location of care with mortality for roughly 2.75 million Medicare beneficiaries (65 years and older) who received invasive mechanical ventilation between 2010 to 2019.

The researchers found that 7.0 percent of patients were treated in rural hospitals. During the study period, the proportion of patients in rural intermediate care increased from 4.1 to 6.3 percent, while patient admissions to urban hospitals remained relatively stable. Adjusted 30-day mortality was similar for patients in rural and urban intensive care units (46.7 percent; adjusted absolute risk difference, −0.1). For patients in rural intermediate care, adjusted 30-day mortality was significantly higher compared with patients in urban intermediate care (37.0 versus 31.3 percent; adjusted absolute risk difference, 5.6 percent).

“There is a need to better understand how intermediate care is used across hospitals and to carefully evaluate the types of patients admitted to intermediate care units,” the authors write.

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