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American Journal of Medical Quality
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Rural Hospital Mortality for Myocardial Infarction in Medicare Patients in Illinois

Roger Hand

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois

Linda Klemka-Walden

Crescent Counties Foundation for Medical Care, Lisle, Illinois

Dale Inczauskis

Crescent Counties Foundation for Medical Care, Lisle, Illinois

Objective: To compare rural and nonrural hospitals for mortality for Medicare patients with myocardial infarction.

Design: A retrospective analysis of variance from Illi nois for the year 1989. Claims were aggregated by hospi tal and the hospitals grouped into geographic areas that were completely rural (N = 32), partially rural with small cities (N = 82), exurban (N = 21), suburban (N = 43), and urban (N = 44).

Patients: 11,753 patients older than 65 years hospital ized for acute myocardial infarction.

Results: In rural hospitals, the mean in-hospital mor tality rate was 24.3% compared to rates of 18.3-20.9% at hospitals in the other four regions (P = 0.10, power = 0.68). Rates for coronary angiography were 0% at rural hospitals compared to 8-20% at hospitals in the other four regions (P <0 0.0005, power = 0.99).

Conclusion : There is a trend toward higher in-hospital mortality for myocardial infarction at rural hospitals. Whether this is caused by their inability to perform cor onary angiography during the index admission warrants further investigation.

American Journal of Medical Quality, Vol. 11, No. 3, 135-141 (1996)
DOI: 10.1177/0885713X9601100304
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