Rural areas, regions outside of Northeast less likely to offer vital cardiac services
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Key takeaways:
- Rural counties were nearly three times more likely to not offer general cardiology services vs. urban counties.
- The Midwest had the greatest odds of not offering diagnostic catheterization.
Rural hospitals were significantly less likely to provide essential cardiac services compared with hospitals in urban areas, according to a research letter published in Circulation.
“Multiple factors contribute to the shortage of health care, especially cardiac services, in rural counties,” Gabriel A. Benavidez, PhD, an epidemiologist and assistant professor in the department of public health at Baylor University, and colleagues wrote. “Notably, while nearly one in five Americans live in rural areas, only 9% to 11% of physicians practice there, largely because of challenges in recruiting and retaining specialists like cardiologists, likely leading to worse cardiac outcomes.”
To investigate geographic disparities in the availability of hospital-based cardiac services in counties across the U.S., Benavidez and colleagues used data from the 2020 American Hospital Association annual survey and the CMS Provider of Services File to determine whether select cardiac services were offered at 4,419 general and community hospitals across 3,145 counties.
The researchers used Rural-Urban Continuum Codes to categorize counties by rurality.
The U.S. census regions used in the analysis included the West, Midwest, Northeast and South.
The study outcome was the presence of a hospital offering one of the following cardiac services: general cardiology, interventional catheterization or diagnostic catheterization.
Overall, 53.5% of hospitals offered general cardiology, 43.7% provided diagnostic catheterization and 40.7% provided interventional catheterization, according to the researchers.
While 72% of urban hospitals offered cardiology services, only 28% of rural hospitals offered the same.
The researchers also found that rural counties were less likely to offer general cardiology services (OR = 2.88; 95% CI, 2.36-3.52) and lack diagnostic (OR = 4.68; 95% CI, 3.75-5.85) and interventional (OR = 5.43; 95% CI, 4.31-6.86) catheterization services compared with urban counties.
Benavidez and colleagues noted that, region-wise, the South was least likely to offer general cardiology (OR = 4.76; 95% CI, 3.21-6.06) and the Midwest was least likely to offer diagnostic catheterization (OR = 4.4; 95% CI, 3.21-5.93) compared with the Northeast.
“Our work adds to the literature demonstrating the consistent lack of health care services in rural areas, while also noting the regional and CHD outcome disparities as well,” the researchers wrote.
“Integrating rural hospitals with urban health care systems via digital platforms can improve access and reduce travel burdens,” the researchers wrote. “Effective policy support is essential to overcome technological and funding barriers, ensuring these solutions reach the communities that need them most.”
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