New Hospital Rankings Assess Hospitals’ Contributions To Community Health With A Focus On Equity

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Health Affairs

Authors:  Caroline F. Plott , Rachel L. J. Thornton, Irene Dankwa-Mullan, Ekta Punwani, Hema Karunakaram, Kyu Rhee, Kelly Jean Thomas Craig, and Joshua M. Sharfstein

US hospitals have some of the most highly trained practitioners, advanced medical treatments, and highest per capita health care spending in the world. Yet, people living in the US have worse health outcomes compared to most high-income nations. From 2015 to 2017, even before the COVID-19 pandemic, life expectancy in the US declined for the first time in nearly a century. In addition, substantial health disparities persist along racial, ethnic, and socioeconomic lines. The COVID-19 pandemic has accentuated and reinforced these disparities: In 2020, Black Americans’ life expectancy has been projected to decrease by three years and Hispanic Americans’ life expectancy by two years, while the country’s overall life expectancy decreased by one year compared to 2017.

This paradox is rooted in the social drivers of health. Economic, environmental, educational, and social factors impact rates of illness in the population. Solutions include investments in primary care and public health, efforts to address the social causes of disease, and a commitment to health equity, defined by the Robert Wood Johnson Foundation as when “everyone has a fair and just opportunity to be as healthy as possible.” The role of hospitals in contributing to these solutions is evolving. In 2017, the National Academies of Medicine found that the most effective hospital contributions to the care of socioeconomically disadvantaged populations are “community informed and patient-centered systems practices” that include (1) commitment to health equity, (2) data and measurement, (3) comprehensive needs assessment, (4) collaborative partnerships, (5) care continuity, and (6) engaging patients in their care. And the call for hospital rankings to incorporate community health and equity into their assessments is growing.

Read the full article.

Changes in Provision of Selected Services by Rural and Urban Hospitals Between 2009 and 2017

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During the past decade, access to healthcare services provided by rural hospitals has changed in two major ways. First, there has been a substantial increase in the number of rural hospitals that have closed or converted (provide some healthcare services but not inpatient care). Secondly, and less understood, many rural hospitals have reduced or terminated services historically considered to be essential hospital services. This brief from the North Carolina Rural Health Research and Policy Analysis Center describes and compares these changes.

U.S. Suicide Rate Drops Contrary to Pandemic Predictions

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The number of U.S. suicides fell nearly six percent last year amid the coronavirus pandemic — the largest annual decline in at least four decades, according to preliminary government data. Death certificates are still coming in and the count could rise. But officials expect a substantial decline will endure, despite worries that COVID-19 could lead to more suicides. It is hard to say exactly why suicide deaths dropped so much, but one factor may be a phenomenon seen in the early stages of wars and national disasters, some experts suggested. Read more.

Vaccine Hesitancy for COVID-19: State, County, and Local Estimates

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To support state and local outreach efforts, HHS researched federal survey data to predict vaccine hesitancy rates down to the county level.  There are two Excel spreadsheets:  one presents state and county estimates of the proportion of adults who describe themselves as “probably not” (Hesitant) or “definitely not” (Strongly Hesitant) going to get a COVID-19 vaccine once one is available to them, and the other presents select sociodemographic and geographic factors by county that can be examined together with the estimates of vaccine hesitancy. See the map here.

FDA Fact Sheets Address Variants for Monoclonal Antibody Products

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The U.S. Food and Drug Administration (FDA) recently released revised fact sheets for health care providers that include additional information on susceptibility of SARS-CoV-2 variants to each monoclonal antibody therapy available through an Emergency Use Authorization for COVID-19 treatment. The fact sheets contain details regarding specific variants and potential resistance. Download revised fact sheets for: Bamlanivimab; Bamlanivimab and Etesevimab and REGEN-COV™ (Casirivimab with Imdevimab).

Study Finds a Third of COVID-19 Survivors Suffer Neurological or Mental Disorders

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A new study published this week found that a third of patients diagnosed with the coronavirus experienced a psychiatric or neurological illness as of six months later. Earlier studies found that COVID-19 can cause long-term brain damage and may increase the risk of Alzheimer’s. As Pennsylvania and the nation approaches April 19 when vaccination will be open to all adults, analysis by Johns Hopkins University of the latest available seven days of data finds that nearly half of new coronavirus infections nationwide are in just five states — New York, Michigan, Florida, Pennsylvania, and New Jersey. The five states together reported 44 percent of the nation’s new COVID-19 infections, or nearly 197,500 new cases. We can change this with vaccination: as of this week, 169 million doses have been given worldwide and 6.8 million in Pennsylvania; 63 million people worldwide and 2.4 million in PA are fully vaccinated against COVID-19.

More Than 20% of Women with Prenatal Medicaid Coverage Became Uninsured After Giving Birth

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Health Affairs released a report on April 6, 2021, which found that 21.9 percent of new mothers with Medicaid-covered prenatal care became uninsured two to six months postpartum. The report, which analyzed Medicaid-covered prenatal care from 2015 to 2018 in 43 states also found that 26.8 percent of new mothers with prenatal Medicaid coverage were uninsured before pregnancy. Data is from the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System.

New Research Highlights Differences Between Urban and Rural Hospitals that Provide Obstetric Services

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New research from the HRSA-funded University of Minnesota Rural Health Research Center shows that among rural hospitals, those hospitals that have stopped providing obstetric care are smaller and more likely to be located in remote rural areas or in majority Black rural counties. This research is critically important for informing programs aimed at addressing disparities in access to maternal health care, like the recently announced RMOMS Program.