Abstract P226: Length Of Stay Discrepancies Between Rural And Urban Hospital Settings For Hypertension Admissions

Abstract

Introduction: Rural populations experience greater barriers to healthcare access compared to urban populations. This can be attributed to fewer public health services, greater uninsured rate, and greater burden of healthcare shortages in urban healthcare settings. Our study aims to quantify the disproportionate allocation in healthcare resources through analysis of Length of Stay (LOS) in-respect to hypertensive urgency and hypertensive urgency. Methods: This cross-sectional study reviewed the LOS estimates for patients with ICD-10 diagnoses for Hypertension Emergency or Hypertension Urgency within the state of New York, categorized by the type of community hospital; rural or urban. This study utilizes the 2020 National Inpatient Sample (NIS), specifically for urban and rural hospitals in New York. ICD-10 codes included I16.1 & I16.9 for Hypertensive Emergency and I16.0 for Hypertensive Urgency. Community hospital setting was categorized as either rural or urban based on the overlying zip code of the admitting inpatient hospital. Results: LOS was unique to the community setting (p<0.01), but not to hypertensive disease (p=0.11). In summary, the LOS was longer in rural-level inpatient hospital systems when compared to their urban counterparts in both Hypertensive Urgency, 4.4 days vs 3.1 days (p=0.01), and Hypertensive Emergency, 5.5 days vs 3.4 days (p<0.01). Conclusion: The LOS of patients admitted for both hypertensive urgency and emergency were significantly higher in rural hospitals. Furthermore, increased disease severity emphasizes the divide in LOS between the community healthcare settings. Redistribution of resources to rural communities can enhance access to preventative healthcare services, specialty healthcare, and potentially decrease overall community disease burden.