Rural Health
Resources by Topic: Emergency department and urgent care services
Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During Covid
Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provider-to-Provider Telemedicine for Sepsis Is Used Less Frequently in Communities with High Social Vulnerability
Examines the relationship between provider-to-provider emergency department-based telehealth consultation (tele-ED) and the prevalence of sepsis in counties with elevated social vulnerability index (SVI) scores. Analyzes 2016-2019 data from 1191 patients treated in rural, Midwestern EDs, with breakdowns according to patient, provider, hospital, and county characteristics. Discusses the relationship between SVI scores and tele-ED use.
Author(s): Kevin J. Tu, J. Priyanka Vakkalanka, Uche E. Okoro, et al.
Citation: Journal of Rural Health, 41(1), e12861
Date: 2025
Type: Document
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Examines the relationship between provider-to-provider emergency department-based telehealth consultation (tele-ED) and the prevalence of sepsis in counties with elevated social vulnerability index (SVI) scores. Analyzes 2016-2019 data from 1191 patients treated in rural, Midwestern EDs, with breakdowns according to patient, provider, hospital, and county characteristics. Discusses the relationship between SVI scores and tele-ED use.
Author(s): Kevin J. Tu, J. Priyanka Vakkalanka, Uche E. Okoro, et al.
Citation: Journal of Rural Health, 41(1), e12861
Date: 2025
Type: Document
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Suicide Care in Kentucky Hospitals
Provides an overview of suicide-related visits in Kentucky hospitals and emergency departments, recent changes, and patient demographics. Features statistics including percentages of suicide-related visits in 2017-2023 in rural and urban Kentucky hospitals, and a county-level map showing locations of psychiatric hospitals.
Date: 12/2024
Type: Document
Sponsoring organization: Kentucky Hospital Association
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Provides an overview of suicide-related visits in Kentucky hospitals and emergency departments, recent changes, and patient demographics. Features statistics including percentages of suicide-related visits in 2017-2023 in rural and urban Kentucky hospitals, and a county-level map showing locations of psychiatric hospitals.
Date: 12/2024
Type: Document
Sponsoring organization: Kentucky Hospital Association
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Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees
Analyzes differences in healthcare utilization among rural versus urban Medicaid enrollees. Utilizes 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files data to examine inpatient and emergency department (ED) use by Rural Urban Commuting Area (RUCA) codes of metropolitan, large rural, small rural, and isolated rural Medicaid populations as well as Frontier and Remote Area (FAR) codes. Includes additional demographic breakdowns by age, race/ethnicity, and sex.
Author(s): Hannah Friedman, Kristie Thompson, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Analyzes differences in healthcare utilization among rural versus urban Medicaid enrollees. Utilizes 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files data to examine inpatient and emergency department (ED) use by Rural Urban Commuting Area (RUCA) codes of metropolitan, large rural, small rural, and isolated rural Medicaid populations as well as Frontier and Remote Area (FAR) codes. Includes additional demographic breakdowns by age, race/ethnicity, and sex.
Author(s): Hannah Friedman, Kristie Thompson, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Identifying Best Practices for Improving the Evaluation and Management of Stroke in Rural Lower-Resourced Settings: A Scientific Statement From the American Heart Association
Discusses the value of quality improvement and expanded stroke service availability in underserved rural and remote settings. Identifies disparities in stroke care access and patient outcomes, and provides strategies related to policy, investment, training, and inter-organizational cooperation which address challenges in prehospital, inpatient, and postacute care, thrombolysis and ED care, patient transfers, and thrombectomy.
Author(s): Kori S. Zachrison, Kaiz S. Asif, Sherita Chapman, et al.
Citation: Stroke
Date: 12/2024
Type: Document
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Discusses the value of quality improvement and expanded stroke service availability in underserved rural and remote settings. Identifies disparities in stroke care access and patient outcomes, and provides strategies related to policy, investment, training, and inter-organizational cooperation which address challenges in prehospital, inpatient, and postacute care, thrombolysis and ED care, patient transfers, and thrombectomy.
Author(s): Kori S. Zachrison, Kaiz S. Asif, Sherita Chapman, et al.
Citation: Stroke
Date: 12/2024
Type: Document
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Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
Type: Document
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Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
Type: Document
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National Hospital Ambulatory Medical Care Survey: 2022 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Type: Document
Sponsoring organization: National Center for Health Statistics
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Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Type: Document
Sponsoring organization: National Center for Health Statistics
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Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators
Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Accountable Health Communities (AHC) Model Evaluation: Third Evaluation Report
Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores which bridge organization and community characteristics were associated with better implementation outcomes, and the beneficiary-level characteristics were associated with a greater probability of accepting navigation, having at least one HRSN resolved, or having all HRSNs resolved. Examines the extent to which bridge organizations met model requirements. Includes information on the availability and quality of community resources to address HRSNs in rural communities.
Additional links: Appendices, Findings at a Glance
Date: 11/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores which bridge organization and community characteristics were associated with better implementation outcomes, and the beneficiary-level characteristics were associated with a greater probability of accepting navigation, having at least one HRSN resolved, or having all HRSNs resolved. Examines the extent to which bridge organizations met model requirements. Includes information on the availability and quality of community resources to address HRSNs in rural communities.
Additional links: Appendices, Findings at a Glance
Date: 11/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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