Quality oversight: Why are rural hospitals less likely to be JCAHO accredited?

There is a large rural-urban disparity in the proportion of hospitals that are accredited by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO). Several factors can influence whether a hospital par ticipates in the accreditation process. A few of those factors include the hospital's size, case mix and ownership. However even after controlling for many of these factors, hospitals in the most rural locations are less like ly to be accredited by the JCAHO than urban hospitals. A survey was conduct ed to explore why rural hospitals are not participating in the accreditatio n process. Survey results show that the largest factor contributing to rura l hospital deterrence to seeking accreditation is cost. Without accreditati on by the JCAHO and compliance with their movement into performance measure ment, quality monitoring of rural hospitals will fall further behind that o f urban hospitals. Policy initiatives that make accreditation move financia lly feasible should be considered.