Examining Rural-Urban Differences in Availability of Hospital Cardiac Testing Services Between 2010-2020

Research center:
Research staff:
Project funded:
September 2022
Project completed:
August 2023

This project examined whether the availability of hospital-based cardiac testing services has changed over the past ten years in rural and urban counties and identified the characteristics of counties where service availability has changed.

We conducted a longitudinal analysis using data from the American Hospital Association (AHA) annual survey from 2010 to 2020. The AHA data was supplemented with data from the American Community Survey for corresponding years and CDC PLACES heart related disease estimates for 2020.

Analytic Method:

  • Cardiac service availability at the county level was determined by geocoding all hospitals in the AHA dataset from 2010 to 2020.
  • Hospitals were flagged if they provided onsite diagnostic catheterization, interventional catheterization, and cardiac rehabilitation.
  • Each cardiac procedure was mutually exclusive from one another.
  • We identified the proportion of counties with at least one hospital providing each of the three mentioned cardiac services each year from 2010 to 2020.
  • Urban Influence Codes were used to stratify the analysis by rurality.
  • Linear trend tests were used to determine whether there are significant differences in the rate of change over time at differing levels of rurality.
  • Sociodemographic characteristics and heart-related disease prevalence of counties that lost or gained cardiac services from 2010 to 2020 were examined.