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Comment and Response |

Mortality Trends in Critical Access Hospitals

John M. Westfall, MD, MPH1; Marc Ringel, MD2; John Gardner, MHA3
[+] Author Affiliations
1Colorado Healthop, Denver
2Retired from Brush Family Medicine, Brush, Colorado
3Yuma District Hospital, Yuma, Colorado
JAMA. 2013;310(4):429-430. doi:10.1001/jama.2013.8739.
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To the Editor Patients living in rural communities require reliable data to make decisions about where to seek care when faced with a serious illness. Unfortunately, Dr Joynt and colleagues1 made a significant error in their methods by not accounting for the large and growing number of patients who present to an ED at a CAH, receive high-quality care, and are transferred to an urban tertiary care hospital directly from the ED. In fact, developing strong partnerships with urban hospitals is a prerequisite for acquiring and maintaining CAH status.

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July 24, 2013
Karen E. Joynt, MD, MPH; John E. Orav, PhD; Ashish K. Jha, MD, MPH
1Harvard School of Public Health, Boston, Massachusetts
JAMA. 2013;310(4):430. doi:10.1001/jama.2013.8745.
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