25 Cities Where You Don’t Want to Get Sick

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15. Homosassa Springs, FL
> 30 day readmission rate: 15.1%
> 30 day mortality rate: 15.4% (highest 10%)
> Preventable hospitalizations: 50.9 per 1,000 patients
> No. of physicians: 56.0 per 100,000 (lowest 25%)
> Median household income: $39,206 (lowest 10%)

Homosassa Springs hospitals actually do better than most metro areas health systems in avoiding readmissions within 30 days. The readmission rate, at 15.1%, is just under the national average of 15.3%. The relatively low overall likelihood of returning to the hospital after the initial visit is due to the particularly low readmission rates among patients with certain conditions, like pneumonia. The readmission rate for Homosassa Springs pneumonia patients is 15.1%, one of the lowest in the country. Unfortunately, this may not be due to quality hospital care. The metro area also reports the nation’s highest 30-day mortality rate for pneumonia patients — 21.8% die shortly after leaving the hospital.

Access to hospital care, as indicated by health insurance coverage rates, actually tends to be relatively good across the 25 cities with the worst-rated hospitals, but not in the Homosassa metro area — where 1 in every 10 area residents do not have health insurance, one of the highest uninsured rates in the nation. Area residents are not especially wealthy. The typical household earns less than $40,000 annually, among the lowest of U.S. metro areas.

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14. Little Rock-North Little Rock-Conway, AR
> 30 day readmission rate: 16.3% (highest 10%)
> 30 day mortality rate: 13.8% (highest 25%)
> Preventable hospitalizations: 50.6 per 1,000 patients
> No. of physicians: 76.0 per 100,000
> Median household income: $51,501

With a population of 734,622 and 12 hospitals (with available data), the Little Rock metro area is one of the larger urban regions and health care systems on this list.

On average, 16.3% of patients return to the hospital 30 days after being admitted, one of the highest 30-day readmission rates of all U.S. metro areas. Nationwide, readmission is highest among heart failure patients, and in Little Rock area’s hospitals this is especially the case. Approximately 24% of patients admitted for heart failure are readmitted within 30 days. Given the poor heart health of the area’s population this readmission rate may suggest, it is likely no coincidence that the 30-day mortality rate for stroke, at 16.5% of patients, is one of the highest such rates.

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13. Peoria, IL
> 30 day readmission rate: 15.8% (highest 25%)
> 30 day mortality rate: 14.5% (highest 10%)
> Preventable hospitalizations: 50.3 per 1,000 patients
> No. of physicians: 83.1 per 100,000
> Median household income: $57,090

Of health conditions tracked by the Centers for Medicare and Medicaid Services, pneumonia is attributed the most deaths of patients in the 30 days after being admitted to hospital. Nationwide, the 30-day mortality rate for pneumonia patients is 15.9%. In Peoria, nearly 19% of pneumonia patients die within 30 days of being admitted to area hospitals, one of the highest rates compared to other U.S. metro areas. Readmission for pneumonia is also relatively common, with hospital return within 30 days occurring for more than 18% of patients.

Peoria area hospitals do relatively well with respect to heart attack patient readmissions. Unlike nearly every other city with the worst-rated hospitals, 15.1% of heart attack patients return to the hospital in the 30 days after being admitted — below the national average rate of 16.3%.

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12. Utica-Rome, NY
> 30 day readmission rate: 16.3% (highest 10%)
> 30 day mortality rate: 13.9% (highest 25%)
> Preventable hospitalizations: 58.4 per 1,000 patients (highest 25%)
> No. of physicians: 66.0 per 100,000
> Median household income: $52,534

Residents of most of the 25 cities with the worst hospitals actually have relatively high health insurance coverage rates, and Utica-Rome is no different. Just 3.4% of area residents do not have health insurance, an especially low rate and less than half the national uninsured rate of 8.6%. With a poverty rate of 16.4%, above the national rate of 14.0%, it is likely many individuals — even with health insurance — struggle to follow doctor’s orders, be it exercise, food, or medicine. High-income individuals tend to be better able to carry out such orders, just as they are more likely to live in communities served by high-rated hospitals.

Comparing Utica-Rome to other U.S. metros, it seems the area may have a shortage of medical professionals. For every 100,000 residents, there are 66 primary care physicians, 30 dentists, and 61 mental health practitioners, each considerably lower than the respective national proportions.

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11. Tuscaloosa, AL
> 30 day readmission rate: 16.3% (highest 10%)
> 30 day mortality rate: 13.8% (highest 25%)
> Preventable hospitalizations: 70.2 per 1,000 patients (highest 10%)
> No. of physicians: 65.0 per 100,000
> Median household income: $46,086 (lowest 25%)

With high quality outpatient treatment and disease management, many hospitalizations can be avoided. A high rate of preventable hospitalizations is one indication that a community’s health needs are not being met. In Tuscaloosa, just shy of the 10 cities with the worst hospitals, there are more than 70 avoidable hospitalizations for every 1,000 patients, considerably higher than the national average rate of 50 per 1,000 patients.

Tuscaloosa residents are not wealthy. The metro area’s median household income of $46,086 a year is in the bottom quarter of all metro areas, and the poverty rate of 18.8% is well above the national poverty rate of 14.0%. Precarious financial situations can exacerbate health conditions and increase the risk of future diagnoses, and this is partially reflected in high readmission rates. Among other adverse health outcomes, the obesity rate in Tuscaloosa of 34.9% is one of the highest in the nation.