AMI is one of the leading causes of death in the United States and a common cause for admission to U.S. hospitals. AMI requires immediate care in a hospital setting to minimize morbidity and mortality. In rural hospital settings, transport of patients with AMI to urban settings could result in delays in care. Some of the most effective and immediate treatments for AMI require only basic intravenous access and should be equally accessible in rural and urban hospitals. The goal of this project was to determined whether overall improvements in the quality of care for AMI among Medicare patients have taken place in both rural and urban hospital settings.

The study population was Medicare beneficiaries 65 years and older with an AMI confirmed by specific medical criteria who were directly admitted for the AMI care (rather than transferred). Rates of AMI guidelines adherence by the three types of rural and urban hospitals were calculated for these hospitals nationally, by region, division, and state in the two time periods. Analyses are complete, and the final report is in preparation.

Publications

• Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing?
  Policy Brief
  WWAMI Rural Health Research Center
  Date: 03/2010
  Overall, there has been improvement in acute myocardial infarction quality measures and persistent rural-urban disparities in only a few. Particularly in small/remote small rural locations, developing strategies to increase use of beneficial discharge medications is important.
• Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing? (Final Report)
  WWAMI Rural Health Research Center
  Date: 03/2010
  In the mid-1990s, quality of care for acute myocardial infarction (AMI) lagged in rural hospitals, with patients in the smallest and remotest hospitals at greatest risk. Overall quality of AMI care has improved in the United States since that time. Whether these improvements have been consistent across rural and urban hospitals is unknown.
• Quality of Care for Myocardial Infarction in Rural and Urban Hospitals
  Journal Article
  WWAMI Rural Health Research Center
  Date: 2010
  In the mid-1990s, significant gaps existed in the quality of acute myocardial infarction (AMI) care between rural and urban hospitals. Since then, overall AMI care quality has improved. This study uses more recent data to determine whether rural-urban AMI quality gaps have persisted.