A recent University of Minnesota School of Public Health Study study found more than 25 percent of rural patients gave birth at non-local hospitals. Among this group, those with higher risk pregnancies were more likely to give birth non-locally, and often at an urban hospital offering higher-level care.
The study also discovered that, even after taking into account clinical complications and risk factors, rural Medicaid beneficiaries were less likely to give birth at a distant facility.
The study was published in the American Journal of Obstetrics and Gynecology.
The overall finding could indicate potential over-triage among higher-income patients in situations where privately insured women receive care at urban hospitals when they could be safely cared for closer to home.
It may also indicate barriers to health care access for low-income patients.
“It’s our hope that these findings shed light on the additional barriers that lower-income patients in rural areas may face to accessing higher-acuity care when needed,” said Dr. Katy Kozhimannil, University of Minnesota School of Public Health associate professor and lead author of the study.
“For example, getting care far from home can entail costs related to travel, transportation, food, and lodging,” said Dr. Kozhimannil. “These expenses may be obstacles to non-local care for patients from lower-income families and conversations between rural patients and providers about clinical referrals to urban hospitals ought to include discussion about ways to overcome these potential barriers.”
Dr. Kozhimannil and her colleagues suggest that implementation of recent ACOG guidelines for maternal care levels will increase transparency about the type of obstetric services available in facilities in both rural and urban areas.