Nonuse of local hospitals by rural Medicare beneficiaries

Previous studies of hospital utilization by rural residents suggest that local hospitals were often bypassed for treatment in larger, urban hospitals. This study examines hospital utilization by aged rural Medicare beneficiaries in Minnesota and Kentucky residing in zip codes that have local hospitals using FY 1987 Medicare discharge data. Most of these beneficiaries were hospitalized locally. Beneficiaries not using hospitals likely did so because cardiovascular surgical procedures were required and were often only performed in large urban teaching hospitals. Bypassing appears to be due to regionalization of care rather than dissatisfaction with local hospitals.