Patients treated at rural emergency departments have similar outcomes to those receiving care at urban ERs for several important emergency conditions, including stroke and heart attack, a new study shows.

Hospitals in the nation’s more remote areas are constantly under threat. Since 2010, over 100 rural United States hospitals have closed, resulting in the loss of emergency department care.

For the new study, researchers analyzed over 470,000 patient outcomes from Medicare beneficiaries treated at rural and urban emergency departments between 2011 and 2015. The results, published in JAMA Network Open, reveal no significant difference in 30-day mortality for potentially life-threatening conditions in the two emergency health care settings.

The similarities in patient outcomes underscore the importance of rural and critical-access emergency departments for treating life-threatening conditions, especially as those facilities risk losing funding and resources, says senior author Keith Kocher, associate professor of emergency medicine at the University of Michigan Medicine.

“The rural emergency department system functions well for discrete conditions that can be quickly diagnosed and approached for treatment and, if necessary, transferred,” Kocher says.

For conditions more related to symptoms that do not result in a specific diagnosis, overall mortality at rural locations was higher than the urban systems. While unmeasured clinical or contextual factors may contribute to worse outcomes for symptom-based cases, the research team says more study and localized analyses are required.

Last year, nearly 20 rural hospitals closed or stopped providing inpatient care. As this trend continues, millions of Americans risk losing valuable health care access within their home communities—care that this study has shown to be valuable and lifesaving, Kocher says.

“This work demonstrates the critical importance of rural emergency departments,” he says. “There are ongoing conversations in policy circles debating the right health care delivery model for rural communities.

Read the full article about new research on rural hospitals by [u'U. Michigan'] at Futurity