Table 5.
Risk-adjusted 30-day mortality rates among Critical Access and non-Critical Access hospitals for common medical conditions.
| AMI | CHF | Pneumonia | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Model specifications | CAH | Non-CAH | Odds Ratio | CAH | Non-CAH | Odds Ratio | CAH | Non-CAH | Odds Ratio |
| Raw mortality rates | 25.2% | 15.2% | 13.8% | 10.6% | 13.0% | 11.9% | |||
| Adjusted for age, sex, race, and medical comorbidities | 23.5% | 16.2% | 1.70 (1.61, 1.80) | 13.4% | 10.9% | 1.28 (1.23, 1.32) | 14.1% | 12.1% | 1.20 (1.16, 1.24) |
| Add use of hospice services | 24.6% | 16.3% | 1.86 (1.75, 1.98) | 14.6% | 11.0% | 1.44 (1.39, 1.49) | 15.0% | 12.2% | 1.32 (1.28, 1.36) |
| Add ownership, region, income | 22.1% | 16.1% | 1.61 (1.51, 1.71) | 13.1% | 11.0% | 1.25 (1.21, 1.30) | 13.6% | 12.3% | 1.14 (1.07, 1.22) |
| Add clinical personnel | 23.2% | 16.0% | 1.75 (1.64, 1.86) | 15.5% | 10.6% | 1.65 (1.46, 1.86) | 13.7% | 12.1% | 1.17 (1.09, 1.26) |
| Add clinical resources, system | 20.0% | 16.1% | 1.39 (1.30, 1.49) | 14.1% | 10.6% | 1.44 (1.27, 1.63) | 13.4% | 12.2% | 1.14 (1.09, 1.19) |
| Add EHR | 20.0% | 16.1% | 1.39 (1.29, 1.49) | 14.1% | 10.6% | 1.44 (1.27, 1.63) | 13.4% | 12.2% | 1.13 (1.05, 1.22) |
| Add condition-specific volume | 19.5% | 15.7% | 1.38 (1.28, 1.48) | 12.6% | 10.6% | 1.25 (1.11, 1.41) | 11.5% | 12.3% | 0.91* (0.85, 0.99) |
| Add rural-urban code (RUCA) | 17.7% | 15.8% | 1.18 (1.09, 1.28) | 11.9% | 10.6% | 1.15* (1.00, 1.31) | 11.5% | 12.3% | 0.92* (0.87, 0.97) |
*
: p<0.05;
p<0.001 for all other comparisons.
AMI=acute myocardial infarction; CHF=congestive heart failure; CAH=Critical Access Hospital; EHR=electronic health record; RUCA=rural-urban commuting area.