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Critical access hospitals (CAHs) provide care to rural, underserved populations, and federal law mandates that this elective designation incur higher Medicare reimbursement rates and exemption from national quality-improvement initiatives. Cross-sectional studies suggest that heath outcomes at CAHs are worse than those at non-CAHs (JW Hosp Med Aug 22 2011).
To examine temporal trends in mortality in CAHs versus non-CAHs between 2002 and 2010, researchers retrospectively compared administrative data for Medicare beneficiaries admitted for pneumonia, congestive heart failure (CHF), and acute myocardial infarction (AMI). Mortality rates were controlled for patient (age, sex, comorbidities), hospital (size, ownership, teaching status, local phys…