Upper Midwest Rural Health Research Center

Completed Projects

Alphabetical list. You can also view by project completion date.

• Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments
  The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment.
  Topics: Health services, Post-acute care, Quality
  
• Assessing the Rural Relevance of Hospital Outpatient Quality Measures
  The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
  Topics: Hospitals and clinics, Quality
  
• Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals
  The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare.
  Topics: Hospitals and clinics, Quality
  
• Critical Access Hospital Readiness for CMS Value-Based Purchasing
  The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals.
  Topics: Critical Access Hospitals (CAHs), Healthcare financing, Quality
  
• Developing Quality Measures and Communication Strategies for Rural Patient Transfers
  The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers.
  Topic: Quality
  
• Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
  The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
  Topics: Hospitals and clinics, Medicare, Post-acute care
  
• Health Information Technology and Quality in Rural Hospitals
  The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas.
  Topics: Health information technology, Hospitals and clinics, Quality
  
• Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions
  This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children.
  Topics: Children and adolescents, Chronic diseases and conditions
  
• Impact of Expansion of Ambulatory Surgery Centers on Rural Hospitals and Communities
  This project will examine the extent of freestanding ambulatory surgery center (ASC) expansion into rural communities between 1998 and 2005, the market factors driving that expansion, and the impact of ASCs on the operational and financial viability of rural hospitals located in the same communities.
  Topics: Health services, Healthcare financing
  
• Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders
  This project examined the types of health insurance coverage of rural Native American elders ages 55 and older, and examine how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban).
  Topics: Aging, American Indians and Alaska Natives, Frontier health, Healthcare access, Minority health, Private health insurance, Rural statistics and demographics, Uninsured and underinsured
  
• Impact of Hospitalists on Inpatient and Primary Care in Rural Communities
  This project will analyze primary data from a survey of rural hospitals about their use of hospitalists along with several sources of secondary data to examine why and how hospitalists are being used in rural hospitals and the impact of their use.
  Topic: Hospitals and clinics
  
• Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
  The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients.
  Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth
  
• Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project
  The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals.
  Topics: Hospitals and clinics, Quality, Workforce
  
• Patient Assessments and Quality of Care in Rural Hospitals
  This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions.
  Topics: Health services, Quality
  
• Pay-for-Performance and Quality Improvement in Rural Hospitals
  This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.
  Topics: Healthcare financing, Hospitals and clinics, Quality
  
• Potentially Preventable Rural Hospital Readmissions
  This project focuses on the analysis of potentially preventable rural hospital readmissions, a potential quality indicator receiving considerable attention from policymakers and payers. Using 3-M algorithm software and MedPAR inpatient claims data from 9 geographically representative states, this study will explore the relationship between readmission rates and geographic regions, categories of rural hospitals, discharge destination, clinical diagnoses and patient attributes.
  Topics: Hospitals and clinics, Quality
  
• Role of Rural Hospitals in Community-Centered Systems of Care: Supporting Population Health Improvement for Rural Communities
  This project will assess the degree to which rural hospitals engage in activities that facilitate community responsiveness and the provision of community-oriented services, using 1996 to 2004 data from the American Hospital Association Annual Survey and the Area Resource File.
  Topics: Health services, Hospitals and clinics
  
• Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
  This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.
  Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Quality, Workforce
  
• Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology and Care Coordination
  The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues.
  Topic: Health services
  
• Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology
  This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals.
  Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality