HealthDay News — Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

Kenton J. Johnston, PhD, from St. Louis University, and colleagues examined a nationally representative survey of Medicare beneficiaries with 1 or more complex chronic conditions representing 61 and 57% of rural and urban Medicare beneficiaries, respectively.

The researchers found that compared with urban residence, rural residence correlated with a 40% higher preventable hospitalization rate and a 23% higher mortality rate. After adjustment for having 1 or more primary care provider visits, having 1 or more specialist visits during the previous year correlated with a 15.9 and 16.6% lower preventable hospitalization rate and lower mortality rate, respectively, for individuals with chronic conditions. Overall, 55% and 40% of the rural-urban differences in preventable hospitalizations and mortality, respectively, were accounted for by access to specialists.

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“We found that access to care, particularly to specialists, explained a sizable portion of the difference in preventable hospitalization and mortality rates between rural and urban beneficiaries,” the authors write.

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