Search

Background US critical access hospitals play an integral role in rural healthcare. Accreditation may be helpful in assuring that these hospitals provide high-quality care. Objective To determine whether quality measures used in the US Centers for Medicare and Medicaid Services Hospital Compare database differed for critical access hospitals based on Joint Commission on Accreditation of Healthcare Organizations accreditation status. Research design Cross-sectional with t-test statistics computed on weighted data to ascertain statistically significant differences (P ≤ 0.01). Main outcome measure Differences between accredited and non-accredited rural critical access hospitals on quality care indicators related to acute myocardial infarction, heart failure, pneumonia and surgical infection. Subjects US critical access hospitals. Results The differences between accredited and non-accredited rural critical access hospitals for 4 out of 16 hospital quality indicators were statistically significant (P ≤ 0.01) and favored accredited hospitals. Also, accredited hospitals were more likely to rank in the top half of hospitals for 6 of the 16 quality measures. Conclusions The results indicate that in the setting of critical access hospitals, external accreditation appears to result in modestly better performance. [ABSTRACT FROM AUTHOR]

: Objective Two recent Institute of Medicine reports highlight that the quality of healthcare in the US is less than what should be expected from the worlds most extensive and expensive healthcare system. This may be especially true for critical access hospitals since these smaller rural-based hospitals often have fewer resources and less funding than larger urban hospitals. The purpose of this paper was to compare quality of hospital care provided in urban acute care hospitals to that provided in rural critical access hospitals. : Design Cross-sectional study analyzing secondary Hospital Compare data. T-test statistics were computed on weighted data to ascertain if differences were statistically significant (P = 0.01). : Setting Centers for Medicare and Medicaid Services hospitals. : Participants US Acute Care and Critical Access hospitals. : Main outcome measures Differences between urban acute care hospitals and rural critical access hospitals on quality care indicators related to acute myocardial infarction, heart failure and pneumonia. : Results For 8 of the 12 hospital quality indicators the differences between urban acute care and rural critical access hospitals were statistically significant (P = 0.01). In seven instances these differences favored urban hospitals. One indicator related to pneumonia favored rural hospitals : Conclusions Although this study focused on only three disease states, these are among the most common clinical conditions encountered in inpatient settings. The findings suggested that there may be differences in quality in rural critical access hospitals and urban acute care hospitals and support the need for future studies addressing disparities between urban acute care and rural critical access hospitals. [ABSTRACT FROM AUTHOR]