Joint replacement surgeries on the rise in rural hospitals: Is it a patient safety issue?

Critical access hospitals across the country are performing more joint replacement surgeries now than in the past — the surgeries performed at critical access hospitals covered by Medicare rose 42.6 percent from 2008 to 2013 — which can be problematic for patient safety, according to the Wall Street Journal.

When surgeons or hospitals host a low volume of certain procedures, patients are at higher risk of suffering death or serious complications, previous analysis has found. The average critical access hospital hosted just 26 joint replacement surgeries in 2013, the Wall Street Journal found, meaning patients there are at greater risk than if they had a joint procedure in a general hospital.

Indeed, the Journal and Harvard researchers found mortality rate for inpatient joint replacements was roughly nine per 1,000 at critical access hospitals, compared to five per 1,000 at general hospitals.

Critical access hospitals are upping the volume of elective joint replacements for a number of reasons, including the payment structure they have with CMS, hiring new surgeons or as the result of a merger.

"Experts say that as the hospitals' experience grows, patients' outcomes should improve," according to the Journal. "But so far, mortality rates have held fast."

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