Rural Patients With Severe Sepsis or Septic Shock Who Bypass Rural Hospitals Have Increased Mortality: An Instrumental Variables Approach.

ABSTRACT:

Objective

To identify factors associated with rural sepsis patients' bypassing rural emergency departments to seek emergency care in larger hospitals, and to measure the association between rural hospital bypass and sepsis survival.

Design

Observational cohort study.

Setting

Emergency departments of a rural Midwestern state.

Patients

All adults treated with severe sepsis or septic shock between 2005 and 2014, using administrative claims data.

Interventions

Patients bypassing local rural hospitals to seek care in larger hospitals.

Measurements and main results

A total of 13,461 patients were included, and only 5.4% (n = 731) bypassed a rural hospital for their emergency department care. Patients who initially chose a top-decile sepsis volume hospit

SUBMITTER: Mohr NM 

PROVIDER: S-EPMC5161646 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature