Medicare paid for 45 percent of all stays in rural hospitals in 2007, while private health insurance paid for 25 percent of such stays, according to a statistical brief from the Agency for Healthcare Research and Quality. In urban hospitals, on the other hand, Medicare paid for 35 percent and private health insurance paid for 36 percent of all stays. Medicare accounted for 55.7 percent of aggregate costs in rural hospitals, compared with 44.3 percent in urban hospitals in 2007. Medicaid was the primary payer for about 20 percent of rural hospital stays, and patients living in the lowest income communities accounted for about 54.7 percent of all rural hospital stays.
Rural hospitalizations accounted for 12.8 percent of all hospitalizations and 9.6 percent of aggregate hospital costs in 2007. On average, costs per stay in rural hospitals were $6,500, compared with $9,000 in urban hospitals. The length of stay was shorter in rural hospitals (3.9 days) than in urban hospitals (4.7 days). In general, the most common principal diagnoses and principal procedures among rural hospital stays and urban hospital stays were similar. The top five principal procedures performed in rural hospitals were circumcision, cesarean section, blood transfusion, upper GI endoscopy, and arthroscopy of knee.
