The study aimed to compare the quality of care and clinical outcomes of patients hospitalized for heart failure (HF) in rural versus urban hospitals in the US. The retrospective cohort study analyzed data from the Get With The Guidelines–Heart Failure (GWTG-HF) registry, including 774,419 patients hospitalized for HF at 569 sites between January 2014 and September 2021. The study found that patients at rural hospitals were less likely to receive some guideline-recommended therapies at discharge, such as cardiac resynchronization therapy and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.
The study also found that patients at rural hospitals had a shorter length of stay compared to those at urban hospitals. However, in-hospital mortality was similar between rural and urban hospitals. Furthermore, the study found no significant differences between rural and urban hospitals in 30-day HF readmission, all-cause readmission, and all-cause mortality among Medicare beneficiaries.
The results suggest that patients hospitalized for HF in rural hospitals may have lower access to some guideline-recommended therapies. Therefore, efforts should be made to improve access to these therapies in rural hospitals to ensure that patients receive optimal care regardless of their geographic location. The study also highlights the need for further research to identify the factors contributing to the disparities in care between rural and urban hospitals.
doi:10.1001/jamacardio.2023.0241
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