Objective: To compare rural and nonrural hospitals for mortality for Medicare patients with myocardial infarction.
Design: A retrospective analysis of variance from Illi nois for the year 1989. Claims were aggregated by hospi tal and the hospitals grouped into geographic areas that were completely rural (N = 32), partially rural with small cities (N = 82), exurban (N = 21), suburban (N = 43), and urban (N = 44).
Patients: 11,753 patients older than 65 years hospital ized for acute myocardial infarction.
Results: In rural hospitals, the mean in-hospital mor tality rate was 24.3% compared to rates of 18.3-20.9% at hospitals in the other four regions (P = 0.10, power = 0.68). Rates for coronary angiography were 0% at rural hospitals compared to 8-20% at hospitals in the other four regions (P <0 0.0005, power = 0.99).
Conclusion : There is a trend toward higher in-hospital mortality for myocardial infarction at rural hospitals. Whether this is caused by their inability to perform cor onary angiography during the index admission warrants further investigation.
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