Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleOriginal Research

Worsening Rural-Urban Gap in Hospital Mortality

Nicole Villapiano, Theodore J. Iwashyna and Matthew M. Davis
The Journal of the American Board of Family Medicine November 2017, 30 (6) 816-823; DOI: https://doi.org/10.3122/jabfm.2017.06.170137
Nicole Villapiano
From the Robert Wood Johnson Foundation Clinical Scholars Program, Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor, MI (NV); VA Center for Clinical Management Research, Ann Arbor and Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor (TJI); Ann & Robert H. Lurie Children’s Hospital, Division of Academic General Pediatrics, Mary Ann and J. Milburn Smith Child Health Research Program, Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (MMD).
MD, MSc
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Theodore J. Iwashyna
From the Robert Wood Johnson Foundation Clinical Scholars Program, Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor, MI (NV); VA Center for Clinical Management Research, Ann Arbor and Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor (TJI); Ann & Robert H. Lurie Children’s Hospital, Division of Academic General Pediatrics, Mary Ann and J. Milburn Smith Child Health Research Program, Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (MMD).
MD, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthew M. Davis
From the Robert Wood Johnson Foundation Clinical Scholars Program, Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor, MI (NV); VA Center for Clinical Management Research, Ann Arbor and Institute for Healthcare Policy and Innovation, Department of Internal Medicine, University of Michigan, Ann Arbor (TJI); Ann & Robert H. Lurie Children’s Hospital, Division of Academic General Pediatrics, Mary Ann and J. Milburn Smith Child Health Research Program, Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (MMD).
MD, MAPP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

References

  1. 1.↵
    1. Ratcliffe M,
    2. Burd C,
    3. Holder K,
    4. Fields A
    . Defining rural at the U.S. Census Bureau. ACSGEO-1. Washington, DC: U.S. Census Bureau, 2016.
  2. 2.↵
    1. Singh GK,
    2. Siahpush M
    . Widening rural-urban disparities in life expectancy. U.S., 1969–2009. Am J Prevent Med 2014;46(2):e19–e29.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Singh GK,
    2. Siahpush M
    . Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969–2009. J Urban Health 2014;91:272–292.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Moy E,
    2. Garcia MC,
    3. Bastian B,
    4. et al
    . Leading causes of death in nonmetropolitan and metropolitan areas—United States, 1999–2014. MMWR Surveill Summ 2017;66:1–8.
    OpenUrlCrossRef
  5. 5.↵
    Center for Medicare and Medicaid Services. Critical access hospitals. Department of Health and Human Services Center for Medicare and Medicaid Services Medicare Learning Network. February 2016. Available from: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/CritAccessHospfctsht.pdf. Accessed January 18, 2017.
  6. 6.↵
    1. Joynt KE,
    2. Orav EJ,
    3. Jha AK
    . Mortality rates for Medicare beneficiaries admitted to critical access and non-critical access hospitals, 2002–2010. JAMA 2013;309:1379–1387.
    OpenUrlCrossRefPubMed
  7. 7.↵
    1. Ibrahim AM,
    2. Hughes TG,
    3. Thumma JR,
    4. Dimick JB
    . Association of hospital critical access status with surgical outcomes and expenditures among Medicare beneficiaries. JAMA 2016;315:2095–2103.
    OpenUrl
  8. 8.↵
    Healthcare Cost and Utilization Project (HCUP) databases. Agency for Healthcare Research and Quality. Available from: http://www.hcup-us.ahrq.gov/databases.jsp. Accessed January 18, 2017.
  9. 9.↵
    1. Ingram DD,
    2. Franco SJ
    . 2013 NCHS urban-rural classification scheme for counties. Vital Health Stat 2014;2:1–73.
    OpenUrl
  10. 10.↵
    1. Elixhauser A,
    2. Steiner C,
    3. Harris DR,
    4. Coffey RM
    . Comorbidity measures for use with administrative data. Med Care 1998;36:8–27.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.↵
    1. Logan H,
    2. Guo Y,
    3. Dodd VJ,
    4. Muller K,
    5. Riley J 3rd.
    . The burden of chronic diseases in a rural North Florida sample. BMC Public Health 2013;13:906.
    OpenUrlCrossRefPubMed
  12. 12.↵
    1. Gamm L,
    2. Hutchison L,
    3. Bellamy G,
    4. Dabney BJ
    . Rural healthy people 2010: Identifying rural health priorities and models for practice. J Rural Health 2002;18:9–14.
    OpenUrlCrossRefPubMed
  13. 13.↵
    1. Smalley KB,
    2. Warren JC,
    3. Klibert J
    . Health risk behaviors in insured and uninsured community health center patients in the rural US South. Rural and remote health 2012;12:2123.
    OpenUrl
  14. 14.↵
    1. Henning-Smith C,
    2. Kozhimannil K,
    3. Prasad S,
    4. Casey M,
    5. Moscovice I
    . Quality measures and sociodemographic risk factors: The Rural Context. University of Minnesota Rural Health Research Center Policy Brief. May 2016. Available from: http://rhrc.umn.edu/wp-content/uploads/2016/05/Quality-Measures-and-Sociodemographic-Risk-Factors.pdf. Accessed January 18, 2017.
  15. 15.↵
    1. Moist LM,
    2. Bragg-Gresham JL,
    3. Pisoni RL,
    4. et al
    . Travel time to dialysis as a predictor of health-related quality of life, adherence, and mortality: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2008;51:641–650.
    OpenUrlCrossRefPubMedWeb of Science
  16. 16.↵
    1. Nicholl J,
    2. West J,
    3. Goodacre S,
    4. Turner J
    . The relationship between distance to hospital and patient mortality in emergencies: An observational study. EMJ 2007;24:665–668.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    1. Herrin J,
    2. St Andre J,
    3. Kenward K,
    4. Joshi MS,
    5. Audet AM,
    6. Hines SC
    . Community factors and hospital readmission rates. Health Serv Res 2015;50:20–39.
    OpenUrlCrossRefPubMed
  18. 18.↵
    1. McCormick B,
    2. Pearson M,
    3. White J
    . Hospital mortality rates and place of death. J Pub Health (Oxf). 2016;38:800–805.
    OpenUrl
  19. 19.↵
    1. Moscovice IS,
    2. Casey MM,
    3. McCullough JS
    . Mortality trends in critical access hospitals. JAMA 2013;310:428–429.
    OpenUrl
  20. 20.↵
    1. Pitches DW,
    2. Mohammed MA,
    3. Lilford RJ
    . What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature. BMC Health Serv Res 2007;7:91.
    OpenUrlCrossRefPubMed
  21. 21.↵
    1. Lilford R,
    2. Pronovost P
    . Using hospital mortality rates to judge hospital performance: A bad idea that just won’t go away. BMJ 2010;340:c2016.
    OpenUrlFREE Full Text
  22. 22.↵
    1. Finlayson SR,
    2. Birkmeyer JD,
    3. Tosteson AN,
    4. Nease RF Jr.
    . Patient preferences for location of care: Implications for regionalization. Med Care 1999;37:204–209.
    OpenUrlCrossRefPubMedWeb of Science
  23. 23.↵
    1. Mehta RH,
    2. Stalhandske EJ,
    3. McCargar PA,
    4. Ruane TJ,
    5. Eagle KA
    . Elderly patients at highest risk with acute myocardial infarction are more frequently transferred from community hospitals to tertiary centers: Reality or myth? Am Heart J 1999;138(4 Pt 1):688–695.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.↵
    National Advisory Committee on Rural Health and Human Services. Rural implications of changes to the medicare hospice benefit. 2013. Available from: https://www.hrsa.gov/advisorycommittees/rural/publications/nacrhhshospicebrief.pdf. Accessed July 13, 2017.
  25. 25.↵
    1. Radcliff TA,
    2. Brasure M,
    3. Moscovice IS,
    4. Stensland JT
    . Understanding rural hospital bypass behavior. J Rural Health 2003;19:252–259.
    OpenUrlCrossRefPubMedWeb of Science
  26. 26.↵
    1. Goldsteen RL,
    2. Falcone DJ,
    3. Broyles RW,
    4. Goldsteen K,
    5. Reilly BJ
    . Local factors affecting the tendency to bypass local hospitals for inpatient mental health care: An exploratory analysis. J Rural Health 1994;10:89–97.
    OpenUrlPubMed
  27. 27.↵
    1. Adams EK,
    2. Wright GE
    . Hospital choice of Medicare beneficiaries in a rural market: Why not the closest? J Rural Health 1991;7(2):134–52.
    OpenUrlPubMed
  28. 28.↵
    1. Escarce JJ,
    2. Kapur K
    . Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California. J Health Care Poor Underserved 2009;20:625–44.
    OpenUrl
  29. 29.↵
    1. Buczko W
    . Rural Medicare beneficiaries’ use of rural and urban hospitals. J Rural Health 2001;17:53–8.
    OpenUrlCrossRefPubMedWeb of Science
  30. 30.↵
    1. Buczko W
    . Bypassing of local hospitals by rural Medicare beneficiaries. J Rural Health 1994;10:237–46.
    OpenUrlPubMed
  31. 31.↵
    1. Hall MJ,
    2. Owings MF
    . Rural residents who are hospitalized in rural and urban hospitals: United States, 2010. NCHS Data Brief 2014;(159):1–8.
  32. 32.↵
    1. Mohr NM,
    2. Harland KK,
    3. Shane DM,
    4. et al
    . Rural patients with severe sepsis or septic shock who bypass rural hospitals have increased mortality: An instrumental variables approach. Crit Care Med 2017;45:85–93.
    OpenUrl
  33. 33.↵
    1. Kleinpell R,
    2. Vasilevskis EE,
    3. Fogg L,
    4. Ely EW
    . Exploring the association of hospice care on patient experience and outcomes of care. BMJ Support Palliat Care 2016 [Epub ahead of print].
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 30 (6)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 6
November-December 2017
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Worsening Rural-Urban Gap in Hospital Mortality
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 8 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Worsening Rural-Urban Gap in Hospital Mortality
Nicole Villapiano, Theodore J. Iwashyna, Matthew M. Davis
The Journal of the American Board of Family Medicine Nov 2017, 30 (6) 816-823; DOI: 10.3122/jabfm.2017.06.170137

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Worsening Rural-Urban Gap in Hospital Mortality
Nicole Villapiano, Theodore J. Iwashyna, Matthew M. Davis
The Journal of the American Board of Family Medicine Nov 2017, 30 (6) 816-823; DOI: 10.3122/jabfm.2017.06.170137
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Rural-urban disparities in hospitalisation for myocardial infarction in systemic lupus erythematosus in the USA
  • Social Determinants of Cardiovascular Disease in US Women with and without Breast Cancer
  • Rural Patient Experiences of Accessing Care for Chronic Conditions: A Systematic Review and Thematic Synthesis of Qualitative Studies
  • Multiple Practical Facts and Ideas to Improve Family Medicine Care
  • Google Scholar

More in this TOC Section

  • Integrating Adverse Childhood Experiences and Social Risks Screening in Adult Primary Care
  • A Pilot Comparison of Clinical Data Collection Methods Using Paper, Electronic Health Record Prompt, and a Smartphone Application
  • Associations Between Modifiable Preconception Care Indicators and Pregnancy Outcomes
Show more Original Research

Similar Articles

Keywords

  • Health Care Disparities
  • Hospital Mortality
  • Hospitalists
  • Rural Health

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire