Rural patients less likely to receive follow-up care after discharge

Rural Medicare patients have lower rates of follow-up care after discharge, an important safeguard against preventable readmissions and other complications, according to a new study published in Medical Care.

Researchers, led by Matthew Toth, Ph.D., then of University of North Carolina Chapel Hill, analyzed data from the Medicare Current Beneficiary Survey covering about 12,000 Medicare patients admitted to hospitals between 2000 and 2010, about a third of whom lived in rural communities. Toth and his team furthered divided the rural patients into those living in large, small and isolated areas.

Comparing rural and urban patients based on follow-up visits, emergency room visits and unplanned readmissions in the first 30 days after hospital discharge, researchers found those in isolared rural areas were 19 percent less likely than their urban counterparts to receive follow-up care. They also found a 44 percent higher risk of ED visits for patients in small rural areas and a 52 percent higher risk for those in large ones.

Risk of readmission was not significantly higher for those living in rural areas than those in urban areas, but when Toth and his team looked at the numbers by hospital location rather than residency, those in large and small rural areas were 32 percent and 42 percent more likely to be readmitted, respectively.