25 Cities Where You Don’t Want to Get Sick

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25. Port St. Lucie, Florida
> 30-day hospital readmission rate: 17.6% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.1% (national rate: 12.4%)
> Preventable hospitalizations: 55 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 48 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $62,608 (national median: $65,712)

In Port St. Lucie, Florida, 17.6% of Medicare enrollees are hospitalized again within 30 days of their discharge, the largest share of any other metro area in the country. High 30-day readmission rates can sometimes be indicative of lower quality care in area hospitals.

The area’s poor performance in measures of quality of care may be partially due to an overreliance on hospitals as a primary treatment option. There are about 55 hospitalizations for conditions that should have been treated in an outpatient setting for every 1,000 Medicare enrollees in Port St. Lucie, a higher preventable hospitalization rate than in the vast majority of U.S. metro areas and well above the national rate of 45 preventable hospitalizations per 1,000.

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24. Monroe, Michigan
> 30-day hospital readmission rate: 16.5% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.5% (national rate: 12.4%)
> Preventable hospitalizations: 58 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 29 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $62,839 (national median: $65,712)

One factor affecting the quality of health care in Monroe, Michigan, may be the relative lack of doctors in the metro area. There are not even 30 primary care physicians per 100,000 residents in Monroe, less than half the national concentration of 75 doctors per 100,000 Americans. With less access to outpatient treatment, Monroe residents may be more likely to visit the hospital for primary care conditions, putting unnecessary strain on hospital resources. There are 58 preventable hospitalizations per 1,000 Medicare enrollees in the area annually, a higher share than most cities in the country and far above the national rate of 45 per 1,000.

Monroe is the only metro area in Michigan — and one of only five metro areas in the Midwest — to rank on this list.

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23. Monroe, Louisiana
> 30-day hospital readmission rate: 16.3% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 11.9% (national rate: 12.4%)
> Preventable hospitalizations: 67 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 74 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $40,136 (national median: $65,712)

One of the main indicators of hospital quality is the share of patients being readmitted after discharge. Readmissions can occur due to poor post-acute care, medical complications during initial hospital stays, poor patient discharge guidance, or for other, non-preventable medical reasons. In Monroe, Louisiana, 15.2% of coronary artery bypass surgery patients are readmitted to the hospital after 30 days, the eighth largest share of any U.S. metro area. Additionally, 22.7% of patients with heart failure return to the hospital within 30 days of discharge, a higher share than most metro areas and higher than the national share of 21.6%.

Another measure of health care quality is the number of patients hospitalized for conditions that are treatable in an outpatient setting — often an indication of poor outpatient treatment. In Monroe, there are 67 preventable hospitalizations per 1,000 Medicare enrollees, the 13th highest preventable hospitalization rate in the country.

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22. Terre Haute, Indiana
> 30-day hospital readmission rate: 15.7% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 11.8% (national rate: 12.4%)
> Preventable hospitalizations: 72 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 74 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $50,129 (national median: $65,712)

In Terre Haute, Indiana, a larger than typical share of residents are hospitalized for conditions that could or should have been treated in an outpatient setting. There are about 72 preventable hospitalizations for every 1,000 Medicare enrollees in the metro area, the fifth highest rate of any metro area, and far higher than the national rate of 45 per 1,000.

As is the case in most metro areas on this list, incomes in Terre Haute tend to be lower than they are nationwide. The median annual household income in the metro area is $50,129, lower than the majority of U.S. cities and well below the national median of $65,715.

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21. Sebring, Florida
> 30-day hospital readmission rate: 16.2% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.5% (national rate: 12.4%)
> Preventable hospitalizations: 62 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 59 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $48,698 (national median: $65,712)

Residents of Sebring, Florida, are more likely to be admitted to the hospital for conditions that should have been treated in an outpatient setting. Such preventable hospitalizations add undue strain on the local health care system, which in Sebring is already likely strained due to the relative scarcity of doctors.

There are only 59 doctors for every 100,000 people in Sebring, a far lower concentration than the comparable national average of 75 physicians for every 100,000 people.