Several critical access hospitals made the list of hospitals in Pennsylvania for which 84% or more patients reported that their room and bathroom were “always” clean. For reference, Pennsylvania’s average rate for patients reporting their room and bathroom were “always” clean is 74 percent. The national average rate for patients reporting their room and bathroom were “always” clean is also 74 percent.
This brief explores two issues. First, the locations of free clinics and their availability in rural counties are examined across all 50 states. This information was derived from clinic listings on the website of the National Association of Free and Charitable Clinics (NAFC). Second, through telephone interviews with leadership at 14 of the 21 state free clinic associations, researchers explored issues facing free clinics during the current period of change. Issues examined include perceived changes in demand subsequent to implementation of the Affordable Care Act and different funding models and strategies used by free clinics.
Some private sector quality initiatives could potentially have a significant impact on the quality of rural health care, particularly in rural markets that are dominated by a single large insurer, as these insurers are likely to have both the resources to implement an initiative and sufficient leverage to motivate rural provider participation. This project examined private sector quality reporting and quality improvement initiatives being implemented by dominant insurers in states with significant rural populations. The policy brief profiles twelve different initiatives (half focused on physician quality improvement, half focused on hospital quality improvement.
Rural hospitals serve as major sources of health care and employment for their communities, but recently they have been under increased financial stress. Although hospital closures are nothing new, the recent pace is unprecedented; the National Rural Health Association has reported that the number of rural hospital closures in the past year was more than in the previous 15 years combined. This article examines why the number of rural hospital closures is accelerating and the effect on communities.
Small rural hospitals are often the sole health care provider in their communities and the only source of care for many people. The provision of surgery in rural hospitals saves the lives of many trauma victims and people with surgical emergencies. Surgery can also have a substantial impact on the finances of a rural hospital as well as the local economy. This study determines the effect of surgery on the profitability of rural hospitals.
This study describes the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals.
The National Advisory Committee of Rural Health and Human Services recently published a policy brief titled ‘Mortality and Life Expectancy in Rural America’. Life expectancy at birth for the population as a whole has been increasing for over a century. In the past few decades, urban-rural disparities in mortality and life expectancy have been increasing. However, rural counties overall have seen smaller increases and some have seen actual declines in life expectancy during that period. The largest disparities in mortality and life expectancy can be found in Appalachia, long a region of persistent rural poverty. Though this brief has a focus on the Appalachian region, it will offer information and recommendations on the topic of rural mortality and life expectancy that are relevant across the nation.
The Federal Office of Rural Health Policy (FORHP) has developed a resource guide for new applicants and grantees. The FORHP Resources Guide is a compendium with an array of relevant resources, tools and services organized by topic area that will assist with the development and sustainability of rural health projects, organizations and networks.
The proportion of physician assistant (PA) graduates who enter practice in rural settings has dropped over the last two decades, though PAs still continue to enter rural practice at a higher rate than primary care physicians. Between 2000 and 2012, 10% of PA training programs produced about 34% of rural PAs; those same programs produced only 14% of all the PAs graduating in the same period. This study identifies the PA training programs that produced high proportions and/or numbers of rural PAs and the program characteristics associated with that success.
More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities, and are therefore an important source of primary care and other essential health services for rural residents. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data on the financial, operational, and quality performance of participating clinics. In light of the significant expansion of quality performance reporting and growing use of performance-based payment approaches, it is critically important that RHCs be able to compete in this changing healthcare market. To this end, we piloted the reporting and use of a small set of primary care-relevant quality measures by a geographically diverse sample of RHCs. This policy brief reports on the results of this pilot with a focus on assessing the feasibility and utility of the reporting system and quality measures for the participating RHCs.