Journal article
Rural-Urban Differences in Surgical Procedures for Medicare Beneficiaries
Archives of surgery (Chicago. 1960), Vol.146(5), pp.579-583
2011
DOI: 10.1001/archsurg.2010.306
PMID: 21242423
Abstract
Objective: To determine whether Medicare beneficiaries in rural areas were less likely to undergo a variety of surgical procedures compared with their urban counterparts. Design, Setting, and Patients: Cross-sectional study of Medicare beneficiaries. Main Outcome Measure: Any incidence of the surgical procedures studied. Results: Compared with urban Medicare beneficiaries, rural Medicare beneficiaries were more likely to undergo a broad array of surgical procedures: 35% more likely for carotid endarterectomy (odds ratio [OR]=1.35; 95% confidence interval [CI], 1.33-1.38), 32% for lumbar spine fusion (OR=1.32; 95% CI, 1.29-1.35), 30% for knee replacement surgery (OR=1.30; 95% CI, 1.28-1.31), 28% for abdominal aortic aneurysm repair (OR=1.28; 95% CI, 1.24-1.31), 22% for prostatectomy (OR=1.22; 95% CI, 1.19-1.24), 19% for hip replacement surgery (OR=1.19; 95% CI, 1.17-1.21), 18% for aortic valve replacement (OR=1.18; 95% CI, 1.14-1.21), 16% for open reduction and internal fixation of the femur (OR=1.16; 95% CI, 1.14-1.18), and 15% for appendectomy (OR=1.15; 95% CI, 1.11-1.19). To determine whether these differences could be explained by known confounding variables, we then used logistic regression to adjust for age, sex, race/ethnicity, median household income, average house value, mean poverty ratio, and state of residence. Rural beneficiaries were still more likely to undergo all of these surgical procedures. Conclusions: Medicare beneficiaries living in rural areas were more likely to undergo a broad array of surgical procedures compared with those living in urban areas. While allaying some concern about rural access to surgical procedures, the uniformity of these results raises concern that people living in rural areas may have an overall poorer quality of health. ©2011 American Medical Association. All rights reserved.
Details
- Title: Subtitle
- Rural-Urban Differences in Surgical Procedures for Medicare Beneficiaries
- Creators
- Mark L Francis - Division of Rheumatology, Texas Tech University Health Sciences Center, El Paso, United StatesSteven L Scaife - Division of Rheumatology, Southern Illinois University School of Medicine, Springfield, United StatesWhitney E Zahnd - Division of Rheumatology, Southern Illinois University School of Medicine, Springfield, United States
- Resource Type
- Journal article
- Publication Details
- Archives of surgery (Chicago. 1960), Vol.146(5), pp.579-583
- DOI
- 10.1001/archsurg.2010.306
- PMID
- 21242423
- NLM abbreviation
- Arch Surg
- ISSN
- 0004-0010
- eISSN
- 1538-3644
- Publisher
- American Medical Association
- Language
- English
- Date published
- 2011
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214810002771
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