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Rural Medicare Beneficiaries Have Fewer Follow-up Visits and Greater Emergency Department Use Postdischarge, Study Finds

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A recent study of elderly Medicare beneficiaries discharged home found lower quality postdischarge care for Medicare beneficiaries in rural settings. Conclusions from the study indicate that as readmission penalties expand, hospitals serving rural beneficiaries may be disproportionately affected, suggesting a need for policies that increase follow-up care in rural settings.

Hospitals are focused on improving postdischarge services for older adults, such as early follow-up care after hospitalization to reduce readmissions and unnecessary emergency department (ED) use. Rural Medicare beneficiaries face many barriers to receiving quality care, but little is known about their postdischarge care and outcomes. The researchers conducted a retrospective analysis of elderly Medicare beneficiaries discharged home using the Medicare Current Beneficiary Survey, Cost and Use files, 2000–2010 to identify if rural Medicare beneficiaries compared with urban beneficiaries, will have fewer follow-up visits, and a greater likelihood of readmission and ED use. Analysis of the results showed that compared with urban beneficiaries, Medicare beneficiaries living in isolated rural settings had a lower rate of follow-up care. Beneficiaries in large and small rural settings had a greater risk of an ED visit compared with urban beneficiaries. Rural beneficiaries did not have a greater risk of readmission, though risk of readmission was higher for beneficiaries discharged from hospitals in large and small rural settings.

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