July 17—Why are rural residents “bypassing” their local hospitals for urban medical centers? For many, the answer is because they are undergoing surgical and nonsurgical procedures, according to new data from the Centers for Disease Control and Prevention (CDC).

“The share of rural residents’ hospitalizations that take place in urban (metropolitan) compared with rural hospitals has been of interest for a number of years,” according to the CDC data brief issued Thursday. “Those who go to urban hospitals have been described as ‘bypassing’ rural hospitals.”

Those who bypass rural hospitals amounted to 40 percent of the 6.1 million rural residents who were hospitalized in 2010. Meanwhile, rural residents who obtained their care from rural hospitals were more likely older and on Medicare compared with those who went to urban areas.

The CDC analysis also found that almost three-quarters of rural residents who traveled to urban areas received surgical or nonsurgical procedures during their hospitalization, compared with only 38 percent of rural residents who were hospitalized in rural hospitals.

Similar Findings

Such findings echoed those of 2010 CDC research, which found that about one-third of rural resident hospitalizations in 2003 were in urban hospitals. Additionally, when holding other factors constant, those undergoing surgery had greater odds of going to urban hospitals.

Care locations for the 17 percent of the U.S. population living in rural areas are a critical issue because small, low-volume rural hospitals have difficulty remaining financially viable under the regular hospital prospective payment system. And some of the special Medicare hospital payment categories have been established to help sustain those providers have raised questions among policymakers.

Publication Date: Thursday, July 17, 2014