Rural Hospital Mortality for Myocardial Infarction in Medicare Patients in Illinois

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Abstract
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 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.

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