title: Lower rehospitalization rates among rural Medicare beneficiaries with diabetes.
abstract: OBJECTIVE
  We estimated the 30-day readmission rate of Medicare beneficiaries with diabetes, across levels of rurality.
  
  
  METHODS
  We merged the 2005 Medicare Chronic Conditions 5% sample data with the 2007 Area Resource File. The study population was delimited to those with diabetes and at least 1 hospitalization in the year. Unadjusted readmission rates were estimated across levels of rurality. Multivariate logistic regression estimated the factors associated with readmissions.
  
  
  RESULTS
  Overall, 14.4% had a readmission; this was higher among urban (14.9%) than rural (12.9%) residents. The adjusted odds indicated that remote rural residents were less likely to have a readmission (OR 0.74, 0.57-0.95) than urban residents. Also, those with a 30-day physician follow-up visit were more likely to have a readmission (OR 2.25, 1.96-2.58) than those without a visit.
  
  
  CONCLUSIONS
  The factors that contribute to hospital readmissions are complex; our findings indicate that access to follow-up care is highly associated with having a readmission. It is possible that residents of remote rural counties may not receive necessary readmissions due to lower availability of such follow-up care. Policy makers should continue to monitor this apparent disparity to determine the impact of these lower rates on both patients and hospitals alike.
authors: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA. kevin.bennett@sc.edu
authors: Kevin J
authors: KJ
authors: Bennett
authors: Janice C
authors: JC
authors: Probst
authors: Medha
authors: M
authors: Vyavaharkar
authors: Saundra H
authors: SH
authors: Glover
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data