SHM Converge Scientific Abstract ePoster Gallery-Rural-Urban Differences in Long-Term Mortality and Readmission Following Covid-19 Hospitalization

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This retrospective multicenter study examined whether rural versus urban residence affected long-term outcomes after COVID-19 hospitalization. Researchers analyzed 9,325 adults admitted to 17 Mayo Clinic hospitals in four U.S. states from March 2020 to July 2022, with follow-up through May 2023. Rurality was classified using the National Center for Health Statistics urban-rural scheme.<br /><br />The main outcomes were all-cause mortality and all-cause readmission after hospitalization. Kaplan-Meier and Cox proportional hazards models were used, adjusting for 30 covariates across demographic, social, comorbidity, and pandemic-year domains. A restricted cohort limited to patients from the four study states was also analyzed to test robustness.<br /><br />Key baseline differences showed rural patients had slightly more comorbid illness and different social characteristics than urban patients. Rural patients were older on average and had higher rates of obesity, heart failure, COPD, depression, and substance use, which may contribute to poorer outcomes.<br /><br />The study found that rural residence was independently associated with worse long-term outcomes. Over a median follow-up of 602 days, rural patients had about 30% higher all-cause mortality and 17% higher readmission risk than urban patients. These disparities persisted across pandemic periods and were consistent in the restricted cohort and most subgroups.<br /><br />The authors conclude that rural-urban disparities in outcomes after COVID-19 hospitalization are not limited to the short term but continue long after discharge. They suggest that worsening of chronic conditions after infection, combined with baseline comorbidity burden and broader access-to-care issues, may explain these findings. The results highlight the need for multidisciplinary strategies to reduce rural health disparities.

Asset Subtitle

Kanika Khandelwal

Meta Tag

Author List Kanika Khandelwal, Mohammed Yousufuddin

Category Research

Concept COVID-19 Hospitalization

Concept All-Cause Mortality

Concept Readmission Rate

Concept Rural Residence

Concept Urban Residence

Distinguished Non-Finalist

Presenter Organization Mayo

Presenting Author Kanika Khandelwal

Track Outcomes Research

Keywords

COVID-19 hospitalization

rural residence

urban residence

long-term outcomes

all-cause mortality

all-cause readmission

rural health disparities

multicenter retrospective study

Cox proportional hazards

Mayo Clinic hospitals

COVID-19 Hospitalization

All-Cause Mortality

Readmission Rate

Rural Residence

Urban Residence