Slide Presentation from the AHRQ 2007 Annual Conference

Conclusion and Implication

• Critical access hospital (CAH) conversion in rural hospitals resulted in enhanced performance of patient safety.
• After conversion, CAHs have better perform in patient safety in the long run.
• We speculate that the likely mechanism involved an increase in financial resources following CAH conversion to cost-based reimbursement for Medicare patients
• Limitations of the study
  • Administrative databases (missing codes, coding errors)
    • We are not able to rule out the possibility of coding behavior change
  • The five indicators may not reflect the whole picture of patient safety in rural hospitals
  • CAH conversion variable is endogeneous.