25 Cities Where You Don’t Want to Get Sick

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5. Lakeland-Winter Haven, FL
> 30-day hospital readmission rate: 16.6%
> Mortality within 30 days of hospitalization: 13.4%
> Preventable hospitalizations: 69.6 per 1,000 Medicare enrollees
> No. of physicians: 49.2 per 100,000
> Median household income: $51,670

For every 1,000 people enrolled in Medicare in the Lakeland metro area, there are about 70 hospitalizations for conditions that could or should have been treated in an outpatient facility. This suggests a possible overreliance on hospitals in the metro area and also potentially a lower than typical quality of care in some outpatient facilities in the metro area.

Also, in Lakeland, those who are hospitalized are more likely to be readmitted within a month of discharge than those discharged from hospitals in the vast majority of other metro areas nationwide. Though unplanned readmissions are not always the fault of the hospital, they can be caused by such conditions as a surgical wound infection. In Lakeland, 16.6% of people discharged from hospitals are readmitted within 30 days, the 10th highest share among U.S. metro areas.

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4. Wheeling, WV-OH
> 30-day hospital readmission rate: 15.8%
> Mortality within 30 days of hospitalization: 14.4%
> Preventable hospitalizations: 72.5 per 1,000 Medicare enrollees
> No. of physicians: 80.4 per 100,000
> Median household income: $49,749

Wheeling is one of many poor metro areas in which the incidence of hospital readmission, post-treatment mortality, and preventable hospitalization is worse than the nation as a whole. The typical household in Wheeling has an annual income of just $49,749, over $12,000 less than the U.S. median.

Adjusted for risk factors such as age, patient health, and the presence of other illnesses, patients in Wheeling are more likely than the average patient to die within a month after being admitted to a hospital. Some 15.3% of heart attack patients die within 30 days of being admitted to the hospital, the seventh largest share of any U.S. metro. Some 19.6% of pneumonia patients and 5.2% of coronary artery bypass patients die within 30 days, the seventh and fifth largest shares, respectively.

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3. Merced, CA
> 30-day hospital readmission rate: 17.5%
> Mortality within 30 days of hospitalization: 14.3%
> Preventable hospitalizations: 52.5 per 1,000 Medicare enrollees
> No. of physicians: 44.7 per 100,000
> Median household income: $57,745

In the Merced, California, metro area, 17.5% of all hospital patients who are discharged are readmitted within 30 days, the third largest share of any metro area in the United States. Though the majority of unplanned hospital readmissions are not preventable, an especially high readmission rate can be indicative of poor quality hospital care.

Adequate physician availability is critical to receiving necessary care, and there are relatively few doctors in the Merced metro area. There are only about 45 primary care physicians for every 100,000 people in Merced, one of the smallest shares among U.S. metro areas and well below the national concentration of 75 per 100,000.

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2. Rocky Mount, NC
> 30-day hospital readmission rate: 16.2%
> Mortality within 30 days of hospitalization: 14.9%
> Preventable hospitalizations: 67.8 per 1,000 Medicare enrollees
> No. of physicians: 47.5 per 100,000
> Median household income: $46,733

Adjusted for risk factors such as age, patient health, and the presence of other illnesses, those recently hospitalized in Rocky Mount are more likely to die — either in the hospital or at home — than patients in almost any other city. Some 14.9% of Rocky Mount residents being treated for conditions like COPD, heart failure, heart attack, pneumonia, and stroke die within 30 days of being admitted to the hospital, the 11th largest share of any U.S. metro area.

Rocky Mount residents are also relatively likely to be admitted to the hospital for conditions that could be treated in an outpatient setting, putting unnecessary strain on hospital resources and exposing themselves to increased risk of infection and other medical complications due to hospital stays. There are 68 preventable hospitalizations per 1,000 Medicare enrollees in Rocky Mount, far more than the national rate of 45 preventable hospitalizations per 1,000 Medicare enrollees nationwide.

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1. Jonesboro, AR
> 30-day hospital readmission rate: 17.1%
> Mortality within 30 days of hospitalization: 13.8%
> Preventable hospitalizations: 68.2 per 1,000 Medicare enrollees
> No. of physicians: 98.6 per 100,000
> Median household income: $43,927

Preventable hospitalizations — or hospitalizations for illnessnesses and conditions that could or should have been treated in an outpatient setting — are an unnecessary strain on hospital resources. In Jonesboro, Arkansas, there are 68 preventable hospitalizations per 1,000 Medicare enrollees, more than in all but 11 other metro areas nationwide. For context, the national preventable hospitalization rate is 45 per 1,000.

The added strain may be impacting the quality of care in the metro area. Hospital readmission rates are one of the most commonly cited measures of the quality of a region’s health care system, and readmissions are relatively common in Jonesboro. Some 17.1% of discharged patients are readmitted to the hospital within 30 days of their initial treatment, a larger share than in all but five other U.S. cities and well over the 15.3% national rate.