Rural hospital mortality for myocardial infarction in Medicare patients in Illinois.
OBJECTIVE
To compare rural and nonrural hospitals for mortality for Medicare patients with myocardial infarction.


METHODS
A retrospective analysis of variance from Illinois for the year 1989. Claims were aggregated by hospital and the hospitals grouped into geographic areas that were completely rural (N = 32), partially rural with small cities (N = 82), exurban (N = 21), suburban (N = 43), and urban (N = 44).


METHODS
11,753 patients older than 65 years hospitalized for acute myocardial infarction.


RESULTS
In rural hospitals, the mean in-hospital mortality rate was 24.3% compared to rates of 18.3-20.9% at hospitals in the other four regions (P = 0.10, power = 0.68). Rates for coronary angiography were 0% at rural hospitals compared to 8-20% at hospitals in the other four regions (P < 0 0.0005, power = 0.99).


CONCLUSIONS
There is a trend toward higher in-hospital mortality for myocardial infarction at rural hospitals. Whether this is caused by their inability to perform coronary angiography during the index admission warrants further investigation.
Hand
R
R
Department of Medicine, University of Illinois at Chicago 60612, USA.
Klemka-Walden
L
L
Inczauskis
D
D
D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data; D006302:Health Services Research; D017052:Hospital Mortality; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D006278:Medicare; D009203:Myocardial Infarction / Q000401:mortality*; D012189:Retrospective Studies; D018881:Suburban Health; D014481:United States