Rural Spotlight

November 25, 2024

Stroke Performance Differences in Rural vs Urban Hospitals

Using data from the American Heart Association’s Get with The Guidelines stroke registry, a recent study assesses how rural hospitals, including stroke centers and non-stroke centers, perform in providing thrombolytic treatment, achieving guideline-recommendations, secondary stroke prevention, and in-hospital outcomes.

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November 25, 2024

How Teletrauma Could Improve Rural Care, Decrease Costs

Teletrauma is a promising approach to improve access to health care expertise using remote consultation. It can bring expertise from a trauma center to injured patients in a non-trauma center, but experts say it is underutilized.

Additionally, telemedicine is enhancing emergency care in rural South Dakota, and the VA has proposed eliminating telehealth copays and expanding access for rural veterans.

Click on the Links Below to Read More:

• UAB research shows lack of Teletrauma use in rural areas; more use could improve care and decrease costs
• Two Years of Telemedicine in Motion: Enhancing Emergency Care Across South Dakota
• VA proposes to eliminate copays for telehealth, expand access to telehealth for rural Veterans

November 25, 2024

Journal of Rural Health Article: Clinical Outcomes and Profitability Following Rural Hospital Mergers and Acquisitions

As US hospital markets become increasingly consolidated, empirical evidence is needed on the clinical and financial impacts of mergers on care provided by rural hospitals. This study identified characteristics of rural hospitals that underwent mergers or acquisitions and examined changes in profitability, clinical outcomes, and patient experience at acquired versus non-acquired rural hospitals.

Findings

Compared to non-acquired hospitals, acquired hospitals were more likely to be for-profit (18.6% vs. 4.6%, p<0.001) and tended to have lower total margins (-1.1% vs. 1.2%; p<0.05) despite higher average clinical volumes. Changes in acquired hospitals’ total margins, patient satisfaction, and risk-adjusted 30-day mortality rates were not different than changes among control hospitals. However, acquisition was associated with lower improvement in 30-day risk-adjusted readmission rates (0.58 percentage point [p.p.] difference in differences, 95% confidence interval -0.88 to -0.28 p.p., p<0.001).

Conclusions

Overall, mergers or acquisitions of rural hospitals were not associated with significant improvements in profitability, clinical outcomes, or patient experience. Policymakers may need to closely monitor rural hospital mergers in order to balance preserving access for rural patients with the consequences of health care consolidation.

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November 25, 2024

Journal of Rural Health Article: Community Responses and Adaptations Following the Closure of a Rural Pharmacy and Primary Care Facility

This study investigates the experiences of one rural community in Central Pennsylvania following the closure of its singular pharmacy and primary health care facility. It aims to understand community members’ responses and adaptations to declining health care accessibility and broader implications for rural health policy and practice.

Findings:

The closure of the health care facilities resulted in significant social and economic impacts, particularly among vulnerable groups, such as older adults, people with disabilities, and working-class families. Participants reported:

• Increased reliance on their social support networks to access care,
• Delays in seeking care due to the strain from longer travel distances,
• Loss of familiar and trusted care providers.

The study also found there to be an over-reliance on local emergency medical services for routine care. Although the community demonstrated resilience through the use of social networks, some adaptations carried health risks, including delayed care and unmonitored use of alternative remedies.

Conclusions

The study highlights the need for health care policies that address the immediate loss of services and support the social networks and economic stability that rural communities rely on in the absence of local health care facilities. This research contributes insights for policymakers, health care providers, and community leaders working to support rural communities facing similar health care losses.

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