A new study in #HSR @WileyHealth examines racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.

Black transfer patients were more likely to be transferred to public hospitals compared with White patients in most models tested. For instance, Black transfer patients were 0.5–1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients treated in the same hospital with the same payer. In comparison, Hispanic transfer patients were − 0.6 pp to −1.2 pp less likely to be transferred to public hospitals than White patients treated in the same hospital with the same payer.

This study suggests large population-level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that these factors may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors.

The study authors include Charleen Hsuan JD PhD, David J. Vanness PhD, Alexis Zebrowski PhD, Brendan G. Carr MD, Edward C. Norton PhD, David G. Buckler MS, Yinan Wang MPP, Douglas L. Leslie PhD, Eleanor F. Dunham MD, MBA, and Jeannette A. Rogowski PhD.

Find more details about the article here.

Researchers at the University of Minnesota Rural Health Research Center used data on hospital ransomware attacks from 2016 to 2021, describing disrupted operations at hospitals in rural and urban areas.

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The Economic Research Service (ERS) at the U.S. Department of Agriculture analyzed natural-cause mortality data for adults aged 25-54 from two three-year periods – 1999 through 2001 and 2017 through 2019.  Researchers found that the mortality rate from natural causes such as chronic disease and cancer in rural areas was only 6 percent higher than for city dwellers during the first period, but the gap widened to 43 percent by 2019.

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This policy brief used American Hospital Association (AHA) survey data to examine partnerships between hospitals and external organizations to address social needs. Hospitals were stratified by rurality (metropolitan or non-metropolitan) and type—prospective payment system (PPS) or critical access hospital (CAH) as well as by region, ownership status and accountable care organization (ACO) participation. We calculated a partnership score for all hospitals reflective of the number of types of partnerships and the number of ways that hospital partner to address social needs with scores ranging from 0 to 48. We also assessed what types of specific partnerships hospitals indicated.  Key findings are noted below:

• The highest mean community partnership scores were seen in metropolitan PPS hospitals (24.0), followed by non-metropolitan PPS hospitals (20.4) and CAHs (16.8).
• Except for non-metropolitan PPS hospitals in the West, the Northeast had the highest mean partnerships across hospital types.
• Regardless of geography or type (CAH or PPS), non-profit hospitals and those participating in ACOs had higher mean partnership scores.

Most hospitals had partnerships with state and local agencies, though compared to other types of hospitals, a higher proportion of metropolitan PPS hospitals had partnerships with organizations that address specific social needs (e.g., food insecurity).

Authors:  Whitney E. Zahnd, PhD; Khyathi Gadag, MHA; Kristin D. Wilson, PhD, MHA; Keith J. Mueller, PhD

Contact Information: Lead Author: Whitney Zahnd, PhD; whitney-zahnd@uiowa.edu

In this brief from the University of Minnesota Rural Health Research center, respondents from advocacy and support organizations identified challenges faced by rural victims across six themes: 1) lack of access to IPV related support services and health care, 2) knowledge and competency limitations among professionals providing services to IPV victims, 3) insufficient resources to meet basic needs, 4) harmful attitudes and norms, 5) detrimental policies and systems, and 6) intersecting risks for IPV victims who belong to marginalized or at-risk groups (e.g., those who are pregnant/postpartum, immigrants, BIPOC [Black, Indigenous, and People of Color], and/or LGBTQ+ [lesbian, gay, bisexual, transgender, queer/questioning]).

Read the full report here.

In a study funded by the National Institutes of Health, researchers examined how expansions for state Medicaid for American Indian/Alaska Native (AI/AN) women were associated with health insurance, prenatal care, health conditions, and birth outcomes. They found Medicaid expansions increased the proportion of AI/AN women reporting healthcare coverage, had no effects on the first-trimester prenatal care usage or birthweight of AI/AN women, and mixed evidence of increased rates of pre-pregnancy chronic conditions after expansions.

Read the full report here.

The RUPRI Center for Rural Health Policy Analysis Explores the extent to which hospitals partner with community organizations to address population and/or community health needs.

Read the full article here.

Researchers at the Rural and Minority Health Research Center assess the availability of in-county diabetes self-management education and dialysis across rural and urban counties.

Read the full report here.

This policy brief  from the University of Minnesota Rural Health Research Center describes findings from interviews with key informants from IPV victim support and advocacy organizations, shedding light on distinct challenges faced by rural victims and survivors. It also highlights targeted opportunities for better supporting the health and safety of rural IPV victims and survivors.

Read the full article here.

A report to Congress from the Medicare Payment Advisory Commission (MedPAC) evaluates Medicare’s fee-for-service payments to providers, the Medicare Advantage and the Part D Prescription Drug Program, special needs plans for beneficiaries who are dually eligible for Medicare and Medicaid, and the new Rural Emergency Hospital provider designation.

Read the full report here.