Table 1.
Demographics, comorbidities, and clinical outcomes stratified by rural bypass status.
| Factor | Treated in Local Hospital (n = 12,730) |
Bypassed Local Hospital (n = 731) |
p |
|---|---|---|---|
| Age, y (mean, SD) | 72.7 (15.4) | 64.7 (15.9) | < 0.001 |
| 18 – 50 y, n (%) | 1245 (10) | 146 (20) | < 0.001 |
| 51 – 69 y, n (%) | 3502 (28) | 291 (40) | |
| 70 – 81 y, n (%) | 3903 (31) | 178 (24) | |
| Over 82 y, n (%) | 4080 (32) | 116 (16) | |
| Non-White, n (%) | 167 (1) | 14 (2) | 0.179 |
| Male, n (%) | 6337 (50) | 389 (53) | 0.071 |
| Rural Residence31, n (%) | 11660 (92) | 604 (83) | < 0.001 |
| Primary Source of Health Insurance | < 0.001 | ||
| Medicare, n (%) | 10251 (81) | 458 (63) | |
| Medicaid, n (%) | 656 (5) | 85 (12) | |
| Commercial, n (%) | 1351 (11) | 143 (20) | |
| Uninsured, n (%) | 404 (3) | 23 (3) | |
| Source of Infection28 | |||
| Pneumonia, n (%) | 4790 (38) | 210 (29) | < 0.001 |
| Urinary Tract Infection, n (%) | 3150 (25) | 106 (15) | < 0.001 |
| Cellulitis and Soft Tissue Infection, n (%) | 884 (7) | 61 (8) | 0.150 |
| Other, n (%) | 4296 (34) | 369 (51) | < 0.001 |
| Surgery During Hospitalization (Broad Definition)50, n (%) | 805 (6) | 69 (9) | 0.001 |
| Comorbidities‡ (Elixhauser methodology)30 | |||
| Congestive Heart Failure, n (%) | 3243 (25) | 192 (26) | 0.634 |
| Valvular Heart Disease, n (%) | 897 (7) | 82 (11) | < 0.001 |
| Peripheral Vascular Disease, n (%) | 1233 (10) | 94 (13) | 0.005 |
| Hypertension, n (%) | 6880 (54) | 421 (58) | 0.061 |
| Neurologic Disorders, n (%) | 1638 (13) | 87 (12) | 0.447 |
| Chronic Pulmonary Disease, n (%) | 3539 (28) | 208 (28) | 0.701 |
| Diabetes Mellitus with Complications, n (%) | 3381 (27) | 202 (28) | 0.024 |
| Renal Failure, n (%) | 3313 (26) | 194 (27) | 0.758 |
| Liver Disease, n (%) | 539 (4) | 72 (10) | < 0.001 |
| Metastatic Cancer, n (%) | 404 (3) | 43 (6) | < 0.001 |
| Inter-Hospital Transfer, n (%) | 7739 (61) | 381 (52) | < 0.001 |
| Inpatient Transfer, n (% among transfers) | 2321 (30) | 249 (65) | < 0.001 |
| Distance | |||
| First Hospital, miles (SD) | 7.3 (11.6) | 58.7 (36.4) | < 0.001 |
| Admitting Hospital, miles (SD) | 40.9 (39.2) | 50.7 (43.4) | < 0.001 |
| Top-Decile Sepsis-Volume Hospital, miles (SD) | 55.1 (25.1) | 41.1 (18.3) | < 0.001 |
| Transfer Distance, miles (SD) | 40.2 (46.7) | 42.1 (54.0) | 0.286 |
| Critical Access Hospital, n (%) | 10413 (82) | 0 (0) | < 0.001 |
| Outcomes | |||
| Hospital Length-of-Stay, median (IQR) | 6 (3–11) | 10 (5–18) | < 0.001 |
| Died, n (%) | 2123 (17) | 153 (21) | 0.003 |
y, year; SD, standard deviation; 95%CI, 95% confidence interval; IQR, interquartile range
‡
For brevity, not all Elixhauser comorbidity variables are listed. The remaining variables either had very low prevalence or had no significant differences between cohorts.
*
All numbered references in this table refer to reference numbers from the main manuscript.