Rural Health
Research Gateway

Hospitals and clinics

Completed Projects

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

  • 21st Century Rural Hospital: Outpatient Services and Access to Care
    The rural hospital has changed dramatically with hospitals becoming increasingly outpatient-centered. This project is designed to inform policymakers about rural hospitals' provision of outpatient care, including publication of a Primer, detailing the variability in outpatient services provision by key characteristics that can be used to examine the potential impact of proposed policy changes on patients' ability to access different services.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • A Comparison of 2017-2019 Uncompensated Care of Rural and Urban Hospitals and a First Look at Uncompensated Care in 2020 and 2021
    This project compared 2017-2019 uncompensated care as a percent of operating expense for rural and urban hospitals and investigated uncompensated care data for 2020 and 2021.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Achieving Equity in Disproportionate Share Payments to Rural Hospitals: An Examination of MedPAC's Revised Disproportionate Share Formula
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Legislation and regulation
  • Advantages and Disadvantages of Hospital-Based Emergency Medical Services in Rural Areas
    This project sought to clarify issues surrounding hospital decisions to acquire and maintain ownership of community ambulance services.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics
  • Affordable Care Act Outreach and Enrollment: Case Studies of Rural Hospitals in Four States
    The purpose of this project is to identify best practices used by rural hospitals to educate uninsured rural patients and consumers about available health insurance coverage options and to assist them in enrolling in a Qualified Health Plan or Medicaid.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Medicaid and CHIP, Uninsured and underinsured
  • After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
    This paper describes opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from centering on inpatient hospital-based care to new models of care delivery in rural places.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Hospitals and clinics, Quality
  • Ambulatory Care Provided to Rural Medicare Beneficiaries by Rural and Urban FQHCs, RHCs, and Acute Hospitals
    This project characterized the volume, cost, and case mix of ambulatory care provided to rural Medicare beneficiaries by rural and urban federally qualified health centers (FQHCs), rural health clinics (RHCs), and acute hospitals. The study included urban-rural and geographic comparisons of volume, cost, and case mix by provider type.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health services, Hospitals and clinics, Medicare
  • Analysis of the Cesarean Section Rates in Rural Hospitals
    This project will describe the practice patterns for deliveries in rural hospitals. Cesarean section rates in rural hospitals will be compared to urban hospitals and the national rate.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Maternal health
  • Assessing Potential Unmet Need for Home Healthcare in Rural Areas
    This study estimated potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We compared rates of home healthcare utilization in rural areas with urban areas, accounting for acute hospital discharges and utilization of inpatient rehabilitation facilities and skilled nursing facilities.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Home health, Hospitals and clinics, Medicare, Post-acute care
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Assessment of Small Rural Hospital Activities to Report Medication Errors
    This research will determine how small rural hospitals have responded to the environmental pressure to improve patient safety and quality by implementing safe medication practices and by reporting and monitoring medication errors.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Burdens of HIPAA on Rural Hospitals
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Legislation and regulation
  • Can a Model Predict Financial Distress Among Rural Hospitals?
    This project will extend an existing model of CAH financial distress to other types of rural hospitals. A valid model would be helpful to ORHP and state Offices of rural Health interested in predicting financial distress or closure of rural hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics
  • Cancer Hospitalizations in Rural-Urban Areas in Relation to Carcinogenic Discharges from Toxics Release Inventory Facilities
    The purpose of the research is to understand whether discharges of carcinogens from Toxics Release Inventory facilities are related to higher cancer hospitalization rates in rural and urban settings. Evidence for this association will have potential implications for improvements to environmental policy or policies for improved cancer detection and treatment in rural settings.
    Research center: West Virginia Rural Health Research Center
    Topics: Cancer, Chronic diseases and conditions, Diabetes, Environmental and agricultural health, Hospitals and clinics, Public health
  • Cancer Prevention and Control Activities in Rural Hospitals
    This project aimed to understand how rural hospitals perceive and implement evidence-based cancer screening and treatment and related intervention strategies.
    Research center: Rural and Minority Health Research Center
    Topics: Cancer, Hospitals and clinics, Minority health
  • Capital Needs of Small Rural Hospitals
    Research center: NORC Walsh Center for Rural Health Analysis
    Topic: Hospitals and clinics
  • Cash Flow of Small Rural Hospitals: The Impact of the Medicare Outpatient Prospective Payment System
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • Change in Service Provision at Rural Hospitals
    The purpose of this study was to compare the services offered by rural hospitals (to urban hospitals) over time (2009-2017) and among rural hospitals of different size, region, rurality, and payment type.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Hospitals and clinics
  • Changes in Care-Seeking After Rural Hospitals Merge
    This project seeks to understand how mergers affect the inpatient care-seeking of markets served by merging hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Hospitals and clinics
  • Changes in Hospital Services Offered After Mergers, Acquisition and Affiliations
    Hospitals have affiliated with systems in increasing numbers since 2007, as of 2016 reaching 56.1 percent of nonmetropolitan prospective payment system hospitals and 42.8 percent of critical access hospitals. This project examined resulting changes in services offered by rural hospitals, hypothesizing shifts of some services to regional hospitals and growth in some service lines.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics, Networking and collaboration
  • Characteristics and Educational Needs of Rural Acute Care Hospital Boards of Directors
    Rural hospital boards face challenges in an environment of increasing legal and financial complexity. This study will characterize rural hospital Board of Directors' backgrounds, perceptions of board function, and perceived need of training and development.
    Research center: Rural and Minority Health Research Center
    Topic: Hospitals and clinics
  • Characteristics of Rural Hospitals at High Risk of Financial Distress
    Updates the Financial Distress Index Model with current hospital and market data. Evaluates changes in risk status and geographic distribution over time. Conducts an in-depth analysis of high risk hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics
  • Clinical-Community Linkages in Non-Metropolitan and Metropolitan Hospitals: COVID-19 Impacts and Trends
    This study examined trends in partnerships between hospitals and public health departments and other community linkages in both non-metropolitan and metropolitan hospitals with a particular focus on the impact of the COVID-19 pandemic.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Networking and collaboration, Public health, Social determinants of health
  • Community and Financial Experience of Medicare Dependent Hospitals in Comparison to Other Rural Hospitals
    This research will investigate the community and financial experience of Medicare Dependent Hospitals (MDHs) in comparison with other rural hospitals. Analysis of the financial experience will include comparison of the long-term profitability of MDHs to other rural hospitals, estimation of the potential profitability consequences of eliminating the payment classification, and estimation of the potential consequences of maintaining the payment classification but failing to update the base year from which costs are trended forward.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
  • Comparison of Coding and Billing Practices Among Selected Small Rural and Urban Hospital Outpatient Departments
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • Comparison of Rural Hospital Closures and the Communities Served, 1990-2020
    This project examined rural hospital closures during three decades to profile community characteristics, health status, health care services, and resources available in communities where rural hospitals have closed.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • Comprehensive Study of Swing Bed Use in Rural Hospitals
    This project will comprehensively address questions about how swing beds are used by rural hospitals. Questions to be answered include whether decision about use are driven by patient need, community resources, hospital operational concerns or some combination of these factors; the cost implications of swing bed use in critical access hospitals to the Medicare program; and whether patients served in swing beds differ in meaningful ways from those in skilled nursing facilities.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
  • Counting Rural Health Care Facilities: A Moving Target?
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Home health, Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
  • Current and Longer Term Challenges of Rural Hospitals: A Survey of Rural Hospital Executives
    This project involved surveying rural hospital executives about how they will respond to current and long-term challenges related to financial and regulatory burdens.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare financing, Hospitals and clinics, Medicare
  • Decline in Inpatient Volume at Rural Hospitals
    The purpose of this study was to compare the decline in inpatient volume of rural hospitals to urban hospitals and among rural hospitals of different size, region, rurality, and payment type.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Hospitals and clinics
  • Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
    This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Legislation and regulation, Maternal health, Women
  • Describing the Health Care Infrastructure in Rural Towns
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Federally Qualified Health Centers (FQHCs), Hospitals and clinics, Physician assistants, Physicians, Rural Health Clinics (RHCs), Rural statistics and demographics
  • Designing a Study for Collection of Uniform Measures by the EB TNGP Grantees
    The Federal Office of Rural Health Policy funded six grantees through the Evidence-Based Telehealth Network Grant Program to implement and evaluate tele-emergency services in rural areas.
    Research center: Rural Telehealth Research Center
    Topic: Hospitals and clinics
  • Developing a Post-COVID Financial Distress Index
    This project updated and improved the North Carolina Rural Health Research Program's Financial Distress Index, which uses historical data about hospital financial performance, government reimbursement, organizational characteristics, and market characteristics to predict the current risk of financial distress.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Developing Relevant Quality Indicators for Rural Hospitals
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Developing Rural-Relevant Strategies to Reduce Maternal Morbidity
    The purpose of this project was to distinguish and analyze predictors of maternal morbidity during childbirth hospitalization by geography and to develop recommendations to improve the safety of childbirth for rural residents. It also assessed the degree of rural focus and representation in current policy efforts to address this crisis.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Legislation and regulation, Maternal health, Quality, Women
  • Discrepancies of Financial Data between Medicare Cost Report and Hospital Audited Financial Statement and Its Implication for Measuring Financial Impact of Payment Policy on Rural Hospitals
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Hospitals and clinics
  • Do Rural Health Clinics (RHCs) Provide Services that Lower Rates of Preventable Hospitalizations?
    This project uses 3 years of individual-level Medicare claims data to analyze the relationship between receiving care at a Rural Health Clinic (RHC) and the likelihood of potentially preventable hospitalization and/or potentially preventable emergency department (ED) visits. The project will explore this relationship among both fee-for-service Medicare enrollees and Medicare-Medicaid dual eligibles.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Hospitals and clinics, Rural Health Clinics (RHCs)
  • Early Rural Experiences of Changes to Medicaid
    This project will 1) develop baseline state-level snapshots of rural enrollment in Medicaid and 2) estimate and model enrollment expansion in each state. We will also conduct a baseline provider key informant interviews in late 2013 to gauge expected effects, with follow up interviews in Summer 2014 as a sentinel warning system of early effects of changes to Medicaid in order to inform timely policy development.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Federally Qualified Health Centers (FQHCs), Hospitals and clinics, Medicaid and CHIP
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Medicare, Post-acute care
  • Effective Strategies for Achieving HIPAA Compliance Among Rural Hospitals
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Legislation and regulation
  • Emergency Department Use by Medically Indigent Rural Residents
    Research center: Rural and Minority Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Uninsured and underinsured
  • Emergency Obstetrics in Communities Without Hospital-Based Maternity Care
    The purpose of this project was to describe rural hospitals that do not provide obstetric services and to survey a sample of these hospitals regarding their capacity for emergency obstetrics locally in order to inform policy to support access to high-quality maternity care for all pregnant rural residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • Estimating the Number of Hospitals that Might Convert to Rural Emergency Hospitals
    This project reviewed the literature to establish what is known about freestanding emergency centers (FECs) and implications for a rural community. The number and types of rural hospitals that would be eligible to convert to an FEC as an alternative to closure of acute inpatient care was estimated.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • Estimation of the Fixed and Variable Costs of a Rural Emergency Hospital
    This project: 1) informed the design of CMS Rural Emergency Hospital (REH) payment methods, particularly the Medicare monthly additional facility payment; 2) estimated patient break-even volumes for the long-run financial sustainability of REHs; and; 3) provided a tool that rural hospitals can use to estimate the cost of operating a REH.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Legislation and regulation, Medicare
  • Examining Rural-Urban Differences in Availability of Hospital Cardiac Testing Services Between 2010-2020
    This project will examine whether the availability of hospital-based cardiac testing services has changed over the past ten years in rural and urban counties and identify the characteristics of counties where service availability has changed.
    Research center: Rural and Minority Health Research Center
    Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Health services, Hospitals and clinics, Public health
  • Examining the Applicability of the AHRQ's Inpatient Quality Indicators to Rural Hospitals and the Implications of the Relationship Between the Indicators and Financial Measures for Medicare Payment Policies
    This study will investigate how the Agency for Healthcare Research and Quality's inpatient quality indicators can be applied to rural hospitals and will explore the application of those indicators in answering relevant policy questions.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Hospitals and clinics, Quality
  • Examining the Magnitudes, Geographic Variations, and Determinants Of Expenditures Due to Ambulatory Care Sensitive Conditions in Rural Hospitals
    This project will document the magnitude of and variation in ambulatory care sensitive condition (ACSC) expenditures of rural hospitals and explore the relationships between rural hospital ACSC expenditure and its key determinants in the areas of population demand, health care system supply, and provider practice style.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Chronic diseases and conditions, Healthcare financing, Hospitals and clinics
  • Exploring Global Budgets as a New Reimbursement Model for Low-Volume Critical Access Hospitals
    Given the complexity of the Global Budget reimbursement model, we were interested to learn if there are aspects of the model that could be applied to consolidate reimbursement across rural and frontier health care settings, particularly for CAHs with low-volume (e.g., < 5 acute patients as a daily census).
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Critical Access Hospitals (CAHs), Healthcare financing, Hospitals and clinics
  • Factors Contributing to Unit Cost Instability in the Low-Volume Hospital
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • Factors Predicting Swing Bed Versus Skilled Nursing Facility Use
    This project updated our 2014 brief: Discharge to Swing Bed or Skilled Nursing Facility: Who Goes Where? In addition to examining health conditions of patients discharged from rural Prospective Payment System hospitals and Critical Access Hospitals to swing beds and skilled nursing facilities, this project also looked to see what has changed over time and whether race and ethnicity, sex, or age explain differences.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Long-term care, Medicare
  • Financial Impact of Outpatient Payment Reform on Rural Hospitals
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health information technology, Hospitals and clinics, Quality
  • High Quality Rural Hospitals and Post-Acute Care Providers
    This project will use several large longitudinal national databases to model alternative ways of identifying high quality rural hospitals, analyze factors related to quality in rural hospitals, and examine the relationship between the quality of care provided by rural hospitals and the quality of care provided by nursing homes and home health agencies within rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Post-acute care, Quality
  • Hospital Readmission Following Care in a Swing Bed
    This study built on our portfolio of swing bed work by examining the rate of hospital readmission for patients who receive post-acute care in swing beds compared to skilled nursing facilities and informed the discussion on use, cost, and benefit of swing bed care.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Post-acute care, Quality
  • How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals?
    This two-year project will explore the effects of changes in insurance coverage under health reform on the following outcomes in rural hospitals: (1) bad debt; (2) charity care; (3) payer mix (Medicare, Medicaid, other); (3) financial performance; and (4) hospital revenue cycle management. Results will inform federal and state agencies, rural providers and communities as to how implementation of the Patient Protection and Affordable Care Act is impacting reimbursement and financial performance of rural hospitals, allowing the Office of Rural Health Policy to identify emerging challenges and develop strategies or policy changes needed to deal with any unintended consequences.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Hospitals and clinics, Private health insurance, Uninsured and underinsured
  • How Have the Sources of Revenue for Rural Hospitals Changed Since 2005?
    Rural hospitals have seen a steadily decreasing average acute daily census. If outpatient revenue is not expanding to fill that decrease, the decrease in patient revenue could further threaten hospital viability.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare
  • How Medicare Payment Standardization Affects the Perceived "Cost" of Post-Acute Care Provided in Critical Access Hospital Swing Beds
    Medicare-allowed charges are adjusted for geographic cost differences and payments that support larger Medicare program goals. This study aimed to identify the effects of the payment standardization method on the perceived "cost" of post-acute care provided in Critical Access Hospital swing beds.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics, Medicare, Post-acute care
  • How Rural Communities Respond and Recover after a Hospital Closure
    Current rates of rural hospital closures are the highest seen in the last few decades. What can we learn from the experiences of communities experiencing hospital closures?
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Workforce
  • How Will Rural Hospitals Meet Requirements for Patient Privacy?
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Care management, Hospitals and clinics, Legislation and regulation
  • Identifying Adverse Drug Events and Improving Patient Safety in Rural Hospitals
    This study identifies rates of adverse drug events (ADEs) and opportunities to improve patient safety in Critical Access Hospitals (CAHs) and non‐CAH rural hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics, Pharmacy and prescription drugs, Quality
  • Identifying Limitations of PPS Reimbursement for Rural Hospitals
    This project will investigate the potential financial and access consequences of returning rural hospitals to PPS payment. Characteristics of the hospitals and communities at highest risk of adverse consequences will be identified.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Hospitals and clinics
  • Impact of the CMS Value-Based Purchasing and Readmission Reduction Programs on Rural Hospitals
    The purpose of this project is to assess the initial impacts of the Value-Based Purchasing (VBP) and Readmission Reduction Programs on rural Prospective Payment System (PPS) hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Hospitals and clinics
  • Impact of the Proposed Medicare Prospective Payment Reforms on Rural Hospitals in Selected States
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth
  • Importance of Surgery to Rural Hospital Financial Condition and Market Share
    This study explores the provision of surgical services in rural hospitals and its relationship to financial performance. The percentage of rural hospitals that offer surgical services and the number that have discontinued surgical services over the last decade will be described, and, for those that have discontinued services, the impact on financial condition will be explored.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • Improvement in the Quality of Care for Acute Myocardial Infarction (AMI): Have Rural Hospitals Followed National Trends?
    This project will determine whether overall improvements in the quality of care for AMI among Medicare patients, as measured by adherence to guidelines, have taken place in both rural and urban hospital settings.
    Research center: WWAMI Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Improving Racial Equity for Rural Mothers and Infants
    The purpose of this project was to assess differences in maternal and infant health outcomes and access to perinatal care, among urban and rural counties. We also compared health outcomes and availability of services, including evidence-based services and supports, between rural counties that are majority Black, Indigenous, and People of Color with those that are majority white.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Minority health, Rural statistics and demographics, Social determinants of health, Women
  • Investments in Health Information Technology by Rural Hospitals
    This study involved a national survey of rural hospitals conducted in late spring 2006 to gather data about readiness to adopt health IT, current use of different technologies, perceptions about the benefits and barriers to health IT adoption, future implementation plans, use of Federal programs designed to facilitate IT adoption, and interest in various health IT policy options.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Health information technology, Hospitals and clinics
  • Labor Costs and the Area Wage Index in Skilled Nursing Facilities
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Long-term care, Workforce
  • Launch of a Study for Collection of Uniform Measures by the EB TNGP Grantees
    Study concepts were vetted, protocols were developed, and this project launched a study where the Evidence-Based Tele-Emergency Network Grant Program grantees began to collect data on a uniform set of measures to help establish the evidence base for tele-ED.
    Research center: Rural Telehealth Research Center
    Topic: Hospitals and clinics
  • Longitudinal Trends in Community Mental Health Center and Federally Qualified Health Center Supply in Nonmetropolitan and Metropolitan Counties
    This study described how the supply of community mental health centers and Federally Qualified Health Centers has changed over time in nonmetropolitan and metropolitan counties nationally.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health promotion and disease prevention, Hospitals and clinics, Mental and behavioral health, Rural Health Clinics (RHCs), Substance use and treatment
  • Making It Work: Models of Success in Rural Maternity Care
    The purpose of this project was to update information on access to obstetric services in rural counties, to identify common factors across rural communities that have maintained local hospital-based obstetric services, and to describe best practices associated with successfully supporting birth locally in rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • Measuring the Quality of Swing Bed Care in Critical Access Hospitals
    This project identified quality measures to be used by Critical Access Hospitals to assess the quality of care provided to their swing bed patients, and recommend appropriate uses of the measures.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Post-acute care, Quality
  • Medicare Payment for Post-Acute Care Transfers
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Post-acute care
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality, Workforce
  • Observation Care Services in Rural Hospitals: Reimbursement and Quality Implications
    This project will describe the nature and scope of observation care services provided by rural hospitals and discuss policy relevant issues for Medicare beneficiaries and providers. Study findings will provide the first assessment of rural observation care services and identify policy options to minimize the potential for unintended consequences of Medicare policies related to observation care services.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Medicare, Quality
  • Obstetric Unit and Hospital Closures and Maternal and Infant Health in Rural Communities
    This project will examine the relationship between closure of an obstetric unit or hospital and maternity care and outcomes of childbirth in rural US counties including prenatal care, distance to delivery hospital, out-of-hospital birth, and infant health outcomes.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Children and adolescents, Health services, Hospitals and clinics, Women
  • Occupational Mix Differences Across PPS Hospitals: Analysis of Hospital Occupation Mix Survey Data and Implications for Rural Hospital Payments
    This study addresses the occupation-mix adjustment that has recently been added to the computation of the area wage index used to adjust Medicare prospective rates for all institutional healthcare providers. The study will review the policy objectives as well as the mechanics of the adjustment, and then analyze the data from the most recent occupation-mix survey to obtain a better understanding of occupation mix differences across labor markets and hospital types.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare Prospective Payment System (PPS), Workforce
  • Options for Structuring Disproportionate Share (DSH) Payments to Account for Uncompensated Care: Impact on Rural Hospitals
    This study will identify options for development of an equitable DSH payment adjustment that accounts for hospital uncompensated care costs and determine the financial impact of each of these proposals on rural hospitals, using simulations with data from Washington, West Virginia, Texas, and Iowa.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics
  • Outpatient Payment Policy Under Medicare: Recent Policy Developments from the Rural Perspective
    This study was designed to examine outpatient payment options for rural hospitals, the advantages and disadvantages of each, and their potential impact on hospital revenue and rural access to health services.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics
  • Patterns of Inpatient Care-Seeking by Rural Residents
    This study seeks to gain an understanding of inpatient care-seeking behavior by rural residents to provide insight into drivers of bypass rates, the extent to which a community uses a hospital other than its local rural hospital.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health services, Hospitals and clinics, Medicare
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Healthcare financing, Hospitals and clinics, Quality
  • Policy Analysis Using the Financial Distress Model: Does Medicaid Expansion Affect the Risk of Hospital Financial Distress and Closure?
    This study will build on the 2014-15 approved project entitled "Can a Model Predict Financial Distress among Rural Hospitals?" The newly developed model uses current financial performance and market characteristic data to assign rural hospitals to one of four categories of risk of financial distress. The study will use Medicare Cost Report data for 2014, if available. Otherwise, simulation will be used to estimate the effects on financial distress.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicaid and CHIP
  • Post-Acute Care for Rural Medicare Beneficiaries
    This project described the variation in the volume, mix and financial importance of post-acute services to rural hospitals; identified hospital and community characteristics associated with variation in post-acute services provided by rural hospitals; and determined where rural Medicare beneficiaries receive post-acute services.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Long-term care, Post-acute care
  • Post-acute Care Trajectories for Rural Medicare Beneficiaries
    Utilization and costs of post-acute care for Medicare fee-for-service beneficiaries have grown rapidly during the last decade. This study examined post-acute care utilization for rural Medicare beneficiaries following acute hospitalization, describing use of home health and skilled nursing care and trajectories of care across settings.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Hospitals and clinics, Medicare, Nurses and nurse practitioners, Post-acute care
  • Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries
    This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates.
    Research center: Rural and Minority Health Research Center
    Topics: Diabetes, Hospitals and clinics, Medicare
  • Potential Impact of ESRD Payment Reform on Rural Dialysis Patients
    This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close.
    Research center: Rural and Minority Health Research Center
    Topics: Health services, Hospitals and clinics
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Preventing Errors in Rural Hospitals
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Provision of Skilled Nursing in Rural America: Skilled Nursing Facilities and Swing Beds
    This project will allow researchers and policy makers to understand the nature of swing bed and skilled nursing facility care provision in rural areas of the U.S. Our national comparison will include indicators such as service mix, length of stay, discharges, volume and census, and certifications and provider characteristics.
    Research center: Southwest Rural Health Research Center
    Topics: Aging, Hospitals and clinics, Long-term care, Medicare
  • Quality Improvement Organizations' Contributions to Rural Hospital Performance
    This qualitative study is designed to gather information on best-practices in Quality Improvement Organization (QIO)-rural hospital partnerships. Specifically, this study will identify successful and replicable examples in which QIOs have worked with rural and critical access hospitals to improve processes of care, implement health information technology and promote organizational safety culture.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Critical Access Hospitals (CAHs), Health information technology, Hospitals and clinics, Quality
  • Quality Measures for Skilled Nursing Care in Rural Swing Beds: What Works and What Doesn't?
    This project provided a systematic review of skilled nursing facility quality measures and how these measures apply to skilled nursing facility-level care provided in rural swing beds in both critical access hospitals and prospective payment system hospitals.
    Research center: Southwest Rural Health Research Center
    Topics: Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS)
  • Quality of Care for Acute Myocardial Infarction Patients in U.S. Rural Hospitals
    Research center: WWAMI Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Quality of Surgical Care services in Critical Access Hospitals (CAHs)
    This project builds on prior work examining rural residents' bypass behavior of their local CAH to hospitals outside their community. Using recently identified inpatient surgical procedures that are commonly performed in CAHs, we will examine and compare outcomes (e.g. post-surgical complication rates, adverse events) of these procedures between CAHs and non-CAHs.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics
  • Rapid Response: Elimination of Bad Debt Payments to Rural PPS Hospitals
    The purpose of this project is to examine: (1) the extent to which elimination of Medicare Bad Debt payments will reduce reimbursement to rural prospective payment system (PPS) hospitals and (2) how rural hospitals would respond to this reduction in reimbursement.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • Role of Free Clinics in the Rural Safety Net
    This two-part study will combine a mapping project that documents the location of free clinics across the US with a telephone survey of the 21 state and 2 regional free clinic associations.
    Research center: Rural and Minority Health Research Center
    Topics: Hospitals and clinics, Rural Health Clinics (RHCs)
  • Role of Inpatient Psychiatric Units in Small Rural Hospitals and Rural Mental Health Systems
    This is a descriptive, exploratory study which will investigate the role of the small rural hospital Inpatient Psychiatric Units from the perspectives of both the rural hospital, in terms of scope of services and revenue enhancement, and the regional mental health system, meeting the needs of outpatient mental health and primary care providers, law enforcement, and human services.
    Research center: Maine Rural Health Research Center
    Topics: Health services, Hospitals and clinics, Mental and behavioral health
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Hospitals and clinics
  • Rural and Urban Differences in Access to Psychiatric Partial Hospitalization Programs
    The project informed policymakers about the accessibility of psychiatric partial hospitalization programs, which provide moderately intensive and structured psychiatric services in outpatient settings, particularly hospital-based outpatient clinics.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Hospitals and clinics, Mental and behavioral health
  • Rural Area Deprivation and Hospitalizations Among Children for Ambulatory Sensitive Conditions
    Rural areas with reduced social and economic resources may be particularly vulnerable to inadequate primary care for children.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Hospitals and clinics
  • Rural Community Response to Hospital Closure
    The Rural Community Response to Hospital Closure project will study how rural communities adapt to local hospital closure. Within selected communities, the project will evaluate the impact of hospital closure on multiple community health-related services and characteristics.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Hospitals and clinics
  • Rural Emergency Department Preparedness for Pediatric Care
    While many large cities have dedicated children's hospitals or facilities with pediatric emergency departments, many general hospitals do not have either the equipment necessary to provide optimal pediatric emergency care nor staff that is specifically trained in the care of pediatric emergencies. This project will use secondary data analysis and semi-structured interviews with emergency room directors in order to address how the availability of pediatric services, expertise and supplies in U.S. emergency departments differs between urban and rural facilities, and to determine which factors impede the availability of pediatric services, expertise, and supplies in rural emergency departments.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Quality, Workforce
  • Rural Hospital Closure and Effect on Local Economies
    Several research projects have analyzed the health effects of rural hospital closures. However, highly cited evidence on the economic effects of rural hospital closures is more than a decade old. The purpose of this study was to quantify the economic impact rural hospital closures have on communities.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • Rural Hospital Closures, 1990-2000: Community Profiles and Economic Indicators Before and After the Event
    This study investigated the economic impact of hospital closures in non- metropolitan counties, taking into account the economic characteristics and employment trends that may have preceded the event.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • Rural Hospital Mergers and Acquisitions - Who is Being Acquired and What Happens Afterwards?
    This study compares the financial and market characteristics of recently acquired rural hospitals to other rural hospitals and investigates the post-acquisition change in services and financial performance of these hospitals. This study will inform rural advocates, federal and state agencies, and regulators as to how mergers and acquisitions (M&amp;As) of small rural hospitals affect access to care for Medicare beneficiaries, and the potential financial consequences of M&amp;As to small rural hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare
  • Rural Hospital Participation in the 340B Drug Discount Program
    The 340B drug discount program enables certain types of safety net organizations to obtain deeply discounted medications, at prices below the 'best price' typically offered to Medicaid agencies. This study used telephone interviews and mail surveys to explore the experiences that rural hospitals have had in seeking 340B eligibility status.
    Research centers: NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs
  • Rural Hospital Wages and the Prospective Payment System Wage Index: 1990-1997
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Workforce
  • Rural Hospitals' Access to Capital
    Research center: University of Minnesota Rural Health Research Center
    Topic: Hospitals and clinics
  • Rural Hospitals' Strategic Response to PPS for Outpatient, SNF, and HH Services
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health services, Home health, Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS)
  • Rural Provider Participation in a Statewide Health Information Project
    Nebraska has recently constructed a communication infrastructure that links all the hospitals in the state with broadband, high-speed systems (using T1 lines to the Critical Access Hospitals). That infrastructure is considered to be the backbone for a statewide health information network being designed by a coalition of organizations. The aim of this project is to delineate reasons for rural providers to participate in the coalition by assessing the associated costs and benefits.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health information technology, Hospitals and clinics, Networking and collaboration
  • Rural Safety Net Provision and Hospital Care in 11 States
    This project evaluated whether access to primary care is more effective at improving health outcomes and reducing costs in rural than urban markets, and identified the characteristics of communities which contribute to improved health outcomes and reducing preventable hospitalizations. This research informs policy relating funding access provision through public clinics to reduce the burden of uncompensated or under-compensated care on financially strained rural hospitals.
    Research center: FORHP-funded Individual Grantees
    Topics: Chronic diseases and conditions, Health services, Hospitals and clinics
  • Rural Women Giving Birth in Non-Local Hospitals: Implications for Obstetric Access and Quality
    The purpose of this project is to: 1) analyze recent data from nine geographically diverse states on delivery by rural women at non-local hospitals; 2) characterize the roles of medical vs. non-medical factors in delivery at a non-local hospital by identifying lower-risk and higher-risk women using established criteria; and 3) analyze the relationship between delivery at a non-local hospital and obstetric quality.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality, Women
  • Rural-urban Comparison of Hospital Financial Performance by Medicare Payment Classification
    This project will compare the financial performance of rural and urban short term general hospitals by Medicare payment classifications (PPS only, Medicare dependent hospitals, sole community hospitals, rural referral centers, and critical access hospitals).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
    The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women
  • Safe Obstetric Care Access for All Rural Residents: Minimum Standards for Clinical, Workforce, and Financial Viability of Rural Obstetric Units
    The goal of this project was to analyze data from rural hospitals to understand the criteria by which hospitals and communities assess their need and capacity for obstetric care access in rural counties and to describe effective ways to operationalize minimum standards for clinical safety and financial viability for rural obstetric units.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Women, Workforce
  • Serious Mental Illness and Access to Care Among Rural and Urban Adults
    Very little research has examined the prevalence of serious mental illness and access to mental health treatment among rural relative to urban adults in the U.S. Using nationally representative data, this project shed new light on the prevalence and correlates of serious mental illness and related access to mental health services.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Hospitals and clinics, Mental and behavioral health, Substance use and treatment
  • Skilled Nursing Facility Care for Rural Residents with Complex Care Needs
    This project will examine barriers to skilled nursing facility placement for rural residents with complex care needs, including obesity, dementia, and behavioral health problems, and explore potential implications for access to and quality of care.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health services, Hospitals and clinics, Long-term care
  • 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.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality
  • The Current Distribution of the General Surgery Workforce in Rural America
    This project described the current national supply and distribution of general surgeons in rural vs. urban areas of the United States as well as geographic variability in the supply of general surgeons across the rural/urban and intra-rural dimensions at the regional level.
    Research center: WWAMI Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Health services, Healthcare access, Hospitals and clinics, Physicians, Rural statistics and demographics, Workforce
  • The Financial and Community Experience of Sole Community Hospitals in Comparison to Other Rural Hospitals
    This research will investigate the financial and community experience of Sole Community Hospitals (SCHs) in comparison with other rural hospitals. The availability of alternative facilities, and the socioeconomic and demographic characteristics of SCH service areas will be compared to other rural hospital service areas.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Rural statistics and demographics
  • The Impact of Emergency Telemedicine on Timeliness, Process of Care, and Clinical Outcomes in Rural North Dakota Trauma Care
    This project was a comparative effectiveness study of North Dakota trauma patients to measure the impact of telemedicine-enabled emergency care between 2008-2014 on a number of issues.
    Research center: Rural Telehealth Research Center
    Topics: Emergency medical services (EMS) and trauma, Emergency preparedness and response, Hospitals and clinics
  • Three Models of a Rural Emergency Hospital
    This project used secondary data about small rural emergency departments and expert opinion to develop three clinical and operational models of a Rural Emergency Hospital (REH). The REH models were based on case mix, service mix, patient volume, clinical staffing, and technology.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Legislation and regulation, Medicare
  • Trends in Swing Bed and Skilled Nursing Facility Use in Rural Hospitals, 1996-2003
    This study will examine trends in the distribution of skilled nursing facility (SNF) services in rural hospitals during a period of dramatic change in Medicare reimbursement, most notably the transition from cost-based reimbursement to SNF prospective payment system (PPS).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Aging, Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS)
  • Understanding Rural Non-Emergent Emergency Department Use
    Research shows rural residents use emergency departments (ED) at higher rates than urban residents. Other studies suggest rural residents are more likely to visit the ED for a non-emergent reasons. This study used the 2014-17 Medical Expenditure Panel Survey to analyze factors associated with rural versus urban residents' non-emergent use of EDs.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Health services, Healthcare access, Hospitals and clinics
  • Understanding the Roles of the Rural Hospital in Responding to Bioterrorist Attacks and Other Emergencies
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Emergency preparedness and response, Hospitals and clinics
  • Use of Emergency Departments for Behavioral Health Related Care
    This project will study the prevalence of emergency department utilization for behavioral health diagnoses between rural and urban communities.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Emergency medical services (EMS) and trauma, Health services, Hospitals and clinics, Mental and behavioral health
  • Use of Home Health Services Among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Hospital Readmission
    This study will examine the 60-day post-acute care outcomes of rural Medicare patients who were discharged from hospitals and admitted to home healthcare services. Key predictors include home health services provided, type of Medicare home health reimbursement, and available community healthcare resources.
    Research center: WWAMI Rural Health Research Center
    Topics: Home health, Hospitals and clinics, Medicare, Post-acute care
  • Utilization of Hospital Care for Rural Medicare Beneficiaries
    This project examines where rural and frontier Medicare beneficiaries access hospital care. Specifically, it explores the different types of inpatient care sought in local rural communities and at tertiary providers. Beneficiary patterns of care by condition, location type and other factors will be examined. The study will also focus on the bypassing behavior of rural residents when being hospitalized. Analysis sensitivity analyses are being performed regarding small travel time differences per alternative hospitals.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Frontier health, Hospitals and clinics, Medicare
  • What Factors Explain Rural Residents Seeking Care Outside of the Rural Community?
    This project will examine factors that explain rural residents seeking care outside of the rural community.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Hospitals and clinics
  • What Happens after Acute Inpatient Care is No Longer Provided by a Rural Hospital?
    This project will investigate the precursors to closure of acute inpatient care by rural hospitals and the post-closure configuration of health care services in the community.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • What is Causing the Increase in Rural Hospital Costs?
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Healthcare financing, Hospitals and clinics
  • What Would be the Financial Consequence of Eliminating Low Volume Hospital Payments?
    Analysis will include comparison of the long-term profitability of low-volume hospitals to other rural hospitals and estimation of the potential profitability consequences of eliminating the payment classification altogether.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)