25 Cities Where You Don’t Want to Get Sick

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15. Gadsden, Alabama
> 30-day hospital readmission rate: 15.9% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 11.9% (national rate: 12.4%)
> Preventable hospitalizations: 74 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 81 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $41,447 (national median: $65,712)

One indication of poor hospital quality is high patient readmission. Some of the reasons readmissions can occur are medical complications during the initial hospital stay or inadequate patient discharge instructions. In Gadsden, 24.6% of all heart failure patients return to the hospital within 30 days of discharge, the fifth highest share of any metro area.

Additionally, Gadsden has the fourth highest preventable hospitalization rate of all metro areas at 74 per 1,000 Medicare enrollees, far higher than the national rate of 45 per 1,000.

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14. Albany, Georgia
> 30-day hospital readmission rate: 15.2% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 15.6% (national rate: 12.4%)
> Preventable hospitalizations: 54 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 63 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $40,625 (national median: $65,712)

Albany, Georgia, has nearly the highest post-hospitalization mortality rate of any U.S. metro area. An estimated 15.6% of residents who are hospitalized for a wide range of conditions die within 30 days after admission, a far larger share than the national 12.4% 30-day mortality rate.

Albany also has far fewer doctors relative to the size of its population than the U.S. as a whole. Across the country, there are 75 primary care physicians for every 100,000 people, compared to just 63 per 100,000 in Albany.

13. Hot Springs, Arkansas
> 30-day hospital readmission rate: 16.6% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 14.0% (national rate: 12.4%)
> Preventable hospitalizations: 47 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 88 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $45,265 (national median: $65,712)

In Hot Springs, Arkansas, people who are hospitalized after suffering heart attacks or with pneumonia are more likely to die than most Americans hospitalized for such conditions. An estimated 14.9% of metro area Medicare enrollees who are treated in a hospital for a heart attack die within 30 days of admission, the eighth largest share among metro areas, compared to 12.9% of enrollees nationwide who do. Nearly one in five pneumonia patients die within 30 days of being admitted, the ninth highest share in the country and well above the national rate of 15.6%.

Hot Springs residents are also far more likely to have to be readmitted to the hospital within a month of discharge than Americans in the vast majority of U.S. metro areas. The city’s 30-day readmission rate is 16.6%, the 10th highest among all metro areas reviewed and higher than the national average of 15.3%.

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12. Johnstown, Pennsylvania
> 30-day hospital readmission rate: 16.2% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 13.4% (national rate: 12.4%)
> Preventable hospitalizations: 59 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 81 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $49,076 (national median: $65,712)

As is the case in most metro areas on this list, Johnston, Pennsylvania, has a high patient readmission rate. While readmissions are often no fault of the hospital, they can occur due to poor post-acute care, medical complications during initial hospital stays, or inadequate patient discharge guidance. In Johnstown, 16.2% of all hospital patients return within 30 days of discharge, compared to a national rate of 15.3%.

Additionally, despite having more than the national average number of doctors per 100,000 people, Johnston residents are more likely to be admitted for conditions that should have been treated in an outpatient setting than the typical American. The preventable hospitalization rate for the metro area is 59 per 1,000 Medicare enrollees, compared to a national rate of 45 per 1,000.

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11. Carbondale-Marion, Illinois
> 30-day hospital readmission rate: 17.1% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.9% (national rate: 12.4%)
> Preventable hospitalizations: 58 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 106 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $46,882 (national median: $65,712)

Carbondale-Marion, Illinois, has one of the highest readmission rates of any metro area in the United States. An estimated 17.1% of local Medicare recipients are readmitted to the hospital within about a month of their initial discharge to the hospital, well above the 15.3% national readmission rate.

Many hospitalizations in Carbondale-Marion are for conditions that could or should have been treated in an outpatient setting. There are 58 preventable hospitalizations for every 1,000 Medicare enrollees in the metro area, well above the 45 per 1,000 national preventable hospitalization rate. These preventable hospitalizations add undue strain on hospital resources.