Quality of Care in Rural Hospitals

Link	View Research Recap
Date	01/2019
Description	This Rural Health Research Recap looks at hospital quality-of-care measures and the difficulties of developing quality measures, especially for rural hospitals with low patient volumes.
Topics	Critical Access Hospitals (CAHs), Hospitals and clinics, Quality

Rural Health Research Products Included in this Recap

• CMS Hospital Quality Star Rating: For 762 Rural Hospitals, No Stars Is the Problem
  Policy Brief
  Rapid Response to Requests for Rural Data Analysis
  Date: 06/2017
  The purpose of this brief is to look more closely at the characteristics of rural hospitals with and without CMS Hospital Quality Star Ratings to help inform ongoing discussions about the usefulness of the quality star rating for comparing hospital quality and possible ways to improve the star rating initiative.
• Critical Access Hospital Swing-Bed Quality Measures: Findings From Key Informant Interviews
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2018
  This study examines how Critical Access Hospitals (CAHs) are currently assessing the quality of care provided to their swing-bed patients.
• Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2017
  Analyzes the prevalence of Adverse Drug Events (ADEs) in rural hospitals, including both CAHs and rural PPS hospitals, related to four categories of drugs: steroids, antibiotics, opiates / narcotics, and anticoagulants in 2013 for eight states. It also examines whether or not these hospitals' ADE rates varied based on hospital characteristics.
• Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 01/2015
  This study's purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.
• Rural Hospital and Physician Participation in Private Sector Quality Initiatives
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 10/2015
  This project examined private sector quality reporting and quality improvement initiatives being implemented by dominant insurers in states with significant rural populations. The policy brief profiles 12 initiatives, half focused on physician quality improvement and half focused on hospital quality improvement.
• Rural Medicare Beneficiaries Have Fewer Follow-Up Visits and Greater Emergency Department Use Post-Discharge
  Journal Article
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 09/2015
  Compares rates of post hospital discharge care among Medicare beneficiaries in rural and urban settings. Discusses the effect on policies for follow-up care and readmission penalties.
• Rural-Urban Differences in Medicare Quality Scores Persist After Adjusting for Sociodemographic and Environmental Characteristics
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  Patient sociodemographic characteristics, such as age, race, gender, income, and education, can affect health outcomes and healthcare providers' performance on quality measures. The discussion about how to tackle these issues around quality measurement haven't included rurality, but this study examines it.
• Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?
  Journal Article
  RUPRI Center for Rural Health Policy Analysis
  Date: 02/2016
  Examines how Critical Access Hospitals perform compared to Prospective Payment System hospitals on measures of quality.
• Use and Performance Variations in U.S. Rural Emergency Departments: Implications for Improving Care Quality and Reducing Costs
  Policy Brief
  North Dakota and NORC Rural Health Reform Policy Research Center
  Date: 02/2015
  This brief describes the variation in emergency department use for non-emergent health conditions across rural and urban areas as well as by U.S. Census regions. Potential risk factors, including patients' socioeconomic characteristics and levels of primary care resources, are identified. Quality of care indicators are also addressed.