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Rural Health
Resources by Topic: Emergency department and urgent care services

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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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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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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How Emergency Departments Are Responding to the Opioid Crisis: Results from a Statewide Survey in Kentucky
Examines hospital emergency departments (EDs) in Kentucky and their substance use disorder (SUD) services. Utilizes 2023 survey data from ED directors and discusses themes such as use of buprenorphine, referrals to community providers, social work services, screening processes, care continuity and more. Includes feedback about access to and availability of SUD services in rural areas.
Author(s): Olivia K. Sugarman, Samantha J. Harris, Lauren Byrne, et al.
Citation: Addiction Science & Clinical Practice, 19, 78
Date: 11/2024
Type: Document
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Dashboard: Acute Behavioral Health Events Along the Birthing Journey in Arkansas
Provides data on acute behavioral health events, including mental health and substance abuse diagnoses, among Arkansas mothers, utilizing 2019-2022 Arkansas Healthcare Transparency Initiative (HTI) data. Features clinical, demographic, and payer data associated with patients and individual encounters, recurring encounters, and outpatient visits, and can be sorted by region and county.
Date: 10/2024
Type: Website
Sponsoring organization: Arkansas Center for Health Improvement
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Costs of Treat-and-Release Emergency Department Visits in the United States, 2021
Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Date: 09/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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A Proposed Method for Identifying Interfacility Transfers in Medicare Claims Data
Discusses a methodology for identifying interfacility transfers (IFTs) to prevent underrepresentation of low-income and rural patients in the data. Utilizes 2011–2020 Medicare claims data of patients with ST-Elevation Myocardial Infarction (STEMI) to examine transfers with breakdowns according to age; sex; race; income; access to emergency department (ED), trauma, or intensive care unit (ICU) care; and metro, micro, or rural location.
Author(s): Sayeh Nikpay, Michelle Leeberg, Katy Kozhimannil, et al.
Citation: Health Services Research
Date: 09/2024
Type: Document
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Implementation of a Rural Emergency Department-initiated Buprenorphine Program in the Mountain West: A Study Protocol
Protocol for a study of emergency department (ED) initiation of buprenorphine treatment for opioid use disorder (OUD) in the rural Mountain West. Discusses study design, implementation strategies, and barriers to OUD treatment access and provision in rural areas.
Author(s): Natasha Seliski, Troy Madsen, Savannah Eley, et al.
Citation: Addiction Science & Clinical Practice, 19, 63
Date: 09/2024
Type: Document
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An REH Conversion Story: Harper County Hospital
Profiles Oklahoma's Harper County Hospital and its transition from a Critical Access Hospital (CAH) to a Rural Emergency Hospital (REH). Summarizes an interview with Kevin O'Brien, Chief Executive Officer (CEO) of Harper County Hospital, regarding the experience of converting to REH status. Covers the hospital's financial position before conversion, including limitations to being a county-owned hospital; the exploration of the REH designation; and the financial and operational impacts of the REH designation, including services added by the hospital after the conversion.
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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An REH Conversion Story: Helena Regional Medical Center
Profiles Helena Regional Medical Center, in Phillips County, Arkansas, and its transition from a prospective payment system (PPS) hospital to a Rural Emergency Hospital (REH). Summarizes the perspective of the hospital's former Chief Executive Officer (CEO) as the facility navigated the change in status, including obstacles, financial and operational impacts, and advantages to operating as an REH.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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