Surgical patient safety outcomes in critical access hospitals: how do they compare?

Natafgi N, Baloh J, Weigel P, Ullrich F, Ward MM. J Rural Health. 2016 Feb 16; [Epub ahead of print].

Care delivery in rural settings is associated with particular patient safety challenges. One issue in rural settings is that patients may obtain care in centers that see fewer patients with their specific condition, and lower volume has been linked to lower quality for various surgical procedures. Using data from the Healthcare Cost and Utilization Project and the American Hospital Association surveys to examine six specific surgical Patient Safety Indicators, this study compared rural critical access hospitals with prospective payment hospitals of similar size. Critical access hospitals had fewer adverse events in the study period. After adjustment for volume, case mix, and hospital characteristics, researchers found that performance was comparable between the two hospital types. This reassuring finding suggests that there are no glaring deficiencies in surgical care at critical access hospitals.