25 Cities Where You Don’t Want to Get Sick

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10. Beckley, West Virginia
> 30-day hospital readmission rate: 15.7% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.5% (national rate: 12.4%)
> Preventable hospitalizations: 76 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 72 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $44,785 (national median: $65,712)

Beckley is one of three metro areas in West Virginia to rank on this list. One of the main indicators of hospital quality is the share of patients being readmitted shortly after discharge. In Beckley, 24.1% of all heart failure patients are readmitted to the hospital 30 days after discharge, the ninth largest share of any U.S. metro area. Additionally, 17.0% of patients who had suffered a heart attack return to the hospital within a month of discharge, the 16th largest share among U.S. metro areas.

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 Beckley, there are 76 preventable hospitalizations per 1,000 Medicare enrollees, the third highest preventable hospitalization rate in the country.

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9. Gulfport-Biloxi-Pascagoula, Mississippi
> 30-day hospital readmission rate: 16.1% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 13.6% (national rate: 12.4%)
> Preventable hospitalizations: 62 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 50 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $50,642 (national median: $65,712)

Gulfport-Biloxi-Pascagoula, Mississippi, has far fewer doctors relative to its population size than much of the rest of the country. There are only 50 primary care physicians for every 100,000 metro area residents, compared to 75 per 100,000 nationwide.

A lack of primary care physicians may partially explain why metro area residents are more likely to go to the hospital for conditions that should be treated in an outpatient facility. There are an estimated 62 preventable hospitalizations for every 1,000 Medicare enrollees in the metro area, well above the 45 per 1,000 national preventable hospitalization rate.

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8. Wheeling, West Virginia-Ohio
> 30-day hospital readmission rate: 15.5% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 12.9% (national rate: 12.4%)
> Preventable hospitalizations: 80 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: $50,440 (national median: $65,712)

In Wheeling, the incidence of hospital readmission, post-treatment mortality, and preventable hospitalization is worse than the nation as a whole.

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 13.3% of heart failure patients die within 30 days of being admitted to the hospital, a higher share than the vast majority of U.S. metro areas. Additionally, Wheeling has the second highest preventable hospitalization rate of U.S. metro areas. About 80 hospitalized patients per 1,000 Medicare enrollees should have been treated in an outpatient facility, compared to 45 per 1,000 in the country as a whole.

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7. Rocky Mount, North Carolina
> 30-day hospital readmission rate: 16.3% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 13.5% (national rate: 12.4%)
> Preventable hospitalizations: 65 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: $46,466 (national median: $65,712)

Rocky Mount, North Carolina, has one of the highest preventable hospitalization rates in the country. There are an estimated 65 hospitalizations for diagnosis that are typically treated in an outpatient facility for every 1,000 Medicare enrollees annually, well above the 45 per 1,000 national rate. A high rate of preventable hospitalizations can be indicative of subpar care in outpatient facilities and also an overuse of urgent care and emergency rooms, which can be a significant burden on hospital resources.

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6. Parkersburg-Vienna, West Virginia
> 30-day hospital readmission rate: 16.5% (national rate: 15.3%)
> Mortality within 30 days of hospitalization: 13.1% (national rate: 12.4%)
> Preventable hospitalizations: 69 per 1,000 Medicare enrollees (national rate: 45 per 1,000)
> No. of primary care physicians: 78 per 100,000 residents (national rate: 75 per 100,000)
> Median household income: $48,680 (national median: $65,712)

Parkersburg-Vienna is one of three West Virginia metro areas to rank among the 10 worst cities for sick people. Poorer areas tend to have underperforming hospital systems and worse health care overall. In the Parkersburg-Vienna metro area, the typical household earns just $48,860 a year, about $17,000 less than the U.S. median.

One indication of poor hospital quality can be high patient readmission. While many hospital readmissions are non-preventable, many are due to poor post-acute care or medical complications during initial treatment. In Parkersburg, 16.5% of all patients return to the hospital within 30 days of discharge, the 12th largest share of any U.S. metro area. The area’s preventable hospitalization rate is also among the highest in the country, at 69 per 1,000 Medicare enrollees, compared to a national rate of 45 per 1,000.