Having a commonplace surger may be
safer when done in a rural hospital compared to a suburban or city hospital, a
new study finds.
"This study gives credence to what rural surgeons long suspected - that
well-done rural surgery is safe and cost-effective," study author Dr.
Tyler Hughes said in a University of Michigan news release. Hughes is one of
only two surgeons at McPherson Hospital in rural McPherson, Kan., and a
director of the American Board of Surgery.
Rural hospitals are also called critical access hospitals. They're the closest
option for tens of millions of patients living outside major cities and
suburban areas, the researchers said.
For the study, the researchers reviewed 1.6 million surgeries. They were
performed at 828 rural hospitals or 3,600 larger hospitals. Specifically, the
researchers compared outcomes for Medicare patients who had one of four common
operations: gallbladder removal, colon surgery, hernia repair and appendix
removal.
There was no difference between hospitals for the risk of dying within 30 days
of an operation. However, researchers found the risk for developing a major
complication after surgery - such as heart attack, pneumonia or kidney damage -
was lower at rural hospitals.
The study also revealed that it cost Medicare about $1,400 less for the same
operation at a rural hospital than at a larger hospital.Patients who had surgery at rural hospitals were also less likely than patients
in larger hospitals to use skilled nursing facilities after their operations,
the researchers said.
The researchers noted that the patients operated on in rural hospitals tended
to be healthier than those treated at larger hospitals, suggesting that rural
doctors select low-risk surgical patients and send more complicated cases to
larger medical centers.
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