Shailendra Prasad, MBBS, MPH
University of Minnesota Rural Health Research Center
Email: shailey@umn.edu
University of Minnesota
Division of Health Policy and Management
2221 University Ave SE, #350
Minneapolis, MN 55455
- Publications - (23)
Publications - (23)
2020
-
Nurse Practitioner Autonomy and Complexity of Care in Rural Primary Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2020
The increasing number of nurse practitioners (NPs) in the rural U.S. has the potential to help alleviate primary care shortages. Using a nationwide source of claims and Electronic Health Record data from 2017, this study constructs measures of NP clinical autonomy and complexity of care. -
Rural and Urban Differences in Primary Care Pain Treatment by Clinician Type
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2020
In this brief, we compare 2017 opioid prescribing rates among physicians and nurse practitioners within primary care practices and how these differ for rural versus urban areas.
2018
-
Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
Journal Article
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. -
Beyond Clinical Complexity: Nonmedical Barriers to Nursing Home Care for Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 02/2018
Using data from interviews with rural hospital discharge planners, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions.
2017
-
Barriers to Nursing Home Care for Nonelderly Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 12/2017
This study uses data from 23 semi-structured interviews with rural hospital discharge planners in five states to identify specific barriers to finding nursing home care for nonelderly rural residents. We found three primary themes—payment status, fit, and medical complexity—as well as two minor themes—caregivers and bureaucratic processes. -
Rural-Urban Differences in Medicare Quality Outcomes and the Impact of Risk Adjustment
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2017
This study examined the differences in quality of care outcomes between rural and urban Medicare beneficiaries. It concluded that rurality should be considered when discussing risk-adjustment procedures. -
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 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. -
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. -
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. -
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
Journal Article
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.
2016
-
Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
Journal Article
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. -
Ensuring Access to High-Quality Maternity Care in Rural America
Journal Article
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. -
Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
Journal Article
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. -
Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
Journal Article
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.
2015
-
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. -
The Rural Obstetric Workforce in U.S. Hospitals: Challenges and Opportunities
Journal Article
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.
2014
-
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 brief details rural hospital obstetric staffing patterns in nine states by critical access hospital status. The purpose was to examine obstetric practice models in rural hospitals, providing information to rural hospitals with obstetric care units regarding workforce and informing policymakers about the context in which the hospitals operate. -
The Use of Hospitalists by Small Rural Hospitals: Results of a National Survey
Journal Article
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. -
Rural-Urban Differences in Obstetric Care 2002-2010 and Implications for the Future
Journal Article
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. -
Birth Volume and the Quality of Care in Rural Hospitals
Journal Article
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.
2013
-
Obstetric Services and Quality Among Critical Access, Rural, and Urban Hospitals in Nine States
University of Minnesota Rural Health Research Center
Date: 06/2013
This policy brief compares the characteristics and quality of obstetric care in critical access hospitals, other rural hospitals, and their urban counterparts.
2010
-
The Effect of Health Information Technology on Quality in U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 04/2010
This study examines changes in quality of care following adoption of electronic health records among a national sample of U.S. hospitals from 2004 to 2007. The use of computerized physician order entry and electronic health records resulted in significant improvements in two quality measures; larger effects in academic than nonacademic hospitals.