Shailendra Prasad, MBBS, MPH

University of Minnesota Rural Health Research Center

Email: shailey@umn.edu

University of Minnesota
Division of Health Policy and Management
420 Delaware Street SE, MMC 729
Minneapolis, MN 55455


Publications - (15)

  • 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.
  • 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.
  • 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.
  • Medical Barriers to Nursing Home Care for Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2017
    This policy brief describes barriers rural residents with complex medical care needs may face when seeking placement in a nursing home and identifies potential policy strategies to overcome them.
  • The Obstetric Care Workforce in Critical Access Hospitals (CAHs) and Rural Non-CAHs
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2014

    This policy brief describes obstetric staffing patterns in rural hospitals in nine states by Critical Access Hospital (CAH) status. The purpose of this study was to examine current obstetric practice models in rural hospitals, with a goal of providing timely and useful information to rural hospitals with obstetric care units regarding the obstetric workforce and to inform policymakers involved in shaping healthcare about the context in which rural hospitals operate.

    Key Findings:

    • In the nine states we studied, almost two-thirds of the 244 rural hospitals (64.3%) had more than one type of clinician providing obstetric care. The most frequent combinations were obstetricians working with certified nurse midwives (CNMs) (17.2% of hospitals) and obstetricians working with family physicians (15.6%).
    • Critical Access Hospitals (CAHs) were significantly more likely than rural non-CAHs to have family physicians and general surgeons attending deliveries, and significantly less likely to have obstetricians attending deliveries.
    • When asked about the challenges they face staffing rural obstetric units, survey respondents most frequently cited census variability, retention and recruitment, maintenance of skills and competencies, and staffing arrangements (scheduling, taking call, unit coverage, etc.).
  • Obstetric Services and Quality among Critical Access, Rural, and Urban Hospitals in Nine States
    University of Minnesota Rural Health Research Center
    Date: 06/2013
    Compares the characteristics and quality of obstetric care in Critical Access Hospitals, other rural hospitals, and their urban counterparts.
  • Quality Measures and Sociodemographic Risk Factors: The Rural Context
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This policy brief aims to inform discussions concerning whether or not to adjust provider quality measures for differences in patient characteristics by examining how rurality and key sociodemographic variables might affect quality-of-care outcomes.
  • 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 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 to analyze current patterns of non-local delivery by rural women's health insurance status and residential rurality.

    Key Findings:

    • In nine geographically-diverse states with substantial rural populations, 25.4% of rural pregnant women delivered their babies in non-local hospitals in 2010 and 2012.
    • Rural women living in more densely populated rural areas were less likely to give birth in a non-local hospital (19.5%) than those in less densely populated rural areas, either next to a metropolitan area (35.9%) or not (33.7%).
    • Privately-insured rural women were more likely to give birth in non-local hospitals than rural women who were covered by Medicaid (28.6% vs. 22.5%).
    • Rural women with Medicaid coverage were more likely than privately-insured women to deliver their babies in a hospital where more than half of all births were covered by Medicaid (63.8% vs. 36.7%).
  • 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 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 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.