• Publications - (24)

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Publications - (24)

• Access to Obstetric Services in Rural Counties Still Declining, with 9 Percent Losing Services, 2004-14
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  Providing access to obstetric care in rural areas is a growing concern. By 2014, about 54% of rural counties in the United States did not have hospital obstetric services.
• Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
  University of Minnesota Rural Health Research Center
  Date: 03/2018
  This study examines whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations.
• Birth Volume and the Quality of Care in Rural Hospitals
  University of Minnesota Rural Health Research Center
  Date: 2014
  Evaluates obstetric care quality in low-, medium-, and high-volume areas by using hospital discharge data.
• Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
• Ensuring Access to High-Quality Maternity Care in Rural America
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
• Factors Associated with High-Risk Rural Women Giving Birth in Non-NICU Hospital Settings
  University of Minnesota Rural Health Research Center
  Date: 07/2016
  Identifies rick factors for childbirth in facilities without neonatal intensive care unit (NICU) capacities among high-risk rural women. The study found that rural women with preterm birthday and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity.
• 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.
• Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  This study looks into the rate at which rural women give birth at nonlocal hospitals. Approximately 75% of rural women gave birth at local hospitals. However, after controlling for clinical complications, rural Medicaid beneficiaries were less likely to give birth at nonlocal hospitals, implying a potential access challenge for this population.
• Minimum Distance Requirements Could Harm High-Performing CAHs and Rural Communities
  North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
  Date: 04/2015
  Compares the effect of location on critical access hospitals' size, quality of care, and financial strength. Discusses implications of minimum distance requirements on critical access hospitals.
• 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.
• Quality Reporting for CAHs and Rural PPS Hospitals: The Potential Impact of Composite Measures
  Policy Brief
  Upper Midwest Rural Health Research Center
  Date: 07/2012
  As a part of a larger project that examined alternative ways of identifying high quality rural hospitals, this report assesses the use of composite scores for public reporting of quality measures as one way of addressing the low volume issue for small rural hospitals.
• Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
  University of Minnesota Rural Health Research Center
  Date: 11/2016
  This study focused on maternity care quality by taking a look at hospitals' policies regarding induced labor and Cesarean deliveries.
• Resources to Reduce Adverse Drug Events in Rural Hospitals
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2017
  This policy brief provides resources that could be used to decrease Adverse Drug Events (ADEs) in rural hospitals.
• Rural Hospital Employment of Physicians and Use of Cesareans and Nonindicated Labor Induction
  University of Minnesota Rural Health Research Center
  Date: 03/2017
  Findings are shared from a study that discovered the types of doctors employed at rural hospitals may make a difference in the rates of cesarean births.
• Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
  University of Minnesota Rural Health Research Center
  Date: 04/2016
  In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
• The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities
  University of Minnesota Rural Health Research Center
  Date: 03/2015
  Describes the healthcare and clinician types who are delivering babies in rural hospitals, such as family physicians, general surgeons, obstetricians, and midwives. Discusses the relationship between hospital birth volume and staffing models.
• Rural Women Delivering Babies in Non-Local Hospitals: Differences by Rurality and Insurance Status
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 06/2015
  This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals and analyzes current patterns of non-local delivery by rural women's health insurance status and residential rurality.
• Rural-Urban Differences in Obstetric Care 2002-2010 and Implications for the Future
  University of Minnesota Rural Health Research Center
  Date: 01/2014
  Measures obstetric care in both rural and urban hospitals to find if trends differ from rural and urban hospital locations.
• State Variability in Access to Hospital-Based Obstetric Services in Rural U.S. Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.
• State Variations in the Rural Obstetric Workforce
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  Many types of staff are necessary to successfully run an obstetrics unit. Rural hospitals face unique staffing challenges. This policy brief describes the obstetric workforce in rural hospitals by state for nine states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin.
• The Practice of Midwifery in Rural US Hospitals
  University of Minnesota Rural Health Research Center
  Date: 07/2016
  Analyzes the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variations on rural CNM practice. CNMs play an important role in the maternity care workforce in rural US hospitals.
• The Use of Hospitalists by Small Rural Hospitals: Results of a National Survey
  University of Minnesota Rural Health Research Center
  Date: 06/2014
  Examines reasons for using hospitalists, characteristics of hospitalist practices, and the impacts of hospitalist use in rural settings.
• Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 10/2015
  The Hospital Readmissions Reduction Program reduces Medicare payments for hospitals with excess rates of patient readmissions for certain conditions. It assesses rural/urban differences in the proportion of hospitals penalized under the program over time and whether condition-specific hospital readmission rates differ for rural/urban hospitals.
• Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
  University of Minnesota Rural Health Research Center
  Date: 08/2016
  Analyzes the reasons behind hospital- and county-level factors for rural obstetric unit closures.