Rural Spotlight

Comparing Health Care in Modern Nations

PubHub has made the following report available:

Measuring the U.S. Health Care System: A Cross-National Comparison

Compares U.S. healthcare data including hospital beds and physicians, hospital and physician visits, healthcare spending, and high-tech procedures per capita, as well as life expectancy with those of twenty-nine other industrialized countries.

How U.S. Health Care Compares to Other Nations

Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. The following report—an update to three earlier editions—includes data from seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.

Find the report by clicking here.

Heart Health

The WWAMI Rural Health Research Center at the University of Washington has released the following publication and report:

Quality of Care for Myocardial Infarction in Rural and Urban Hospitals

To view other projects and publications, click here.

New Ideas for Common Areas of Concern

PubHub has made the following reports available:

Developing Innovative Payment Approaches: Finding the Path to High Performance

Discusses issues in facilitating, under the 2010 health reform law, initiatives to identify, develop, implement, and monitor payment and delivery system reforms to improve quality and control costs while supporting the fiscal integrity of public programs.

Outside the Box: Case Studies in Creative Clinic Design

Examines the role of well-designed safety-net facilities that support new models of care. Outlines two California clinics' conception and building; ability to serve community health, education, employment, and environmental needs; and lessons learned.

Scoring the Social Mission of Colleges

Recent research has found that some colleges and universities are more likely to promote physicians working in underserved areas. The regions and specific locations of the schools had a great impact on their social mission scores.  Read an article on the research by clicking here.

Pediatric Care in Rural Hospital Emergency Departments

Two new publications are available from the North Carolina Rural Health Research & Policy Analysis Center that analyzed data from the Emergency Pediatric Services and Equipment Supplement(EPSES) to the National Hospital Ambulatory Medical Care Survey (NHAMCS). Rural and urban hospitals’ responses on various dimensions of pediatric ED care. Aso surveyed, were 65 ED directors at rural hospitals in a separate process to explore rural pediatric ED care in more detail and to obtain the opinion of rural ED administrators regarding ways to assure quality emergency care for children.

Findings Brief #96 "Pediatric Care in Rural Hospital Emergency Departments"

The full report, Final Report #97 "Pediatric Care in Rural Hospital Emergency Departments"

Key findings from this study include:

Analysis of the EPSES data using a comprehensive definition of rural and urban found the following:
Rural hospitals had a lower ED visit volume and were less likely to be teaching hospitals or to have a children’s hospital in their county. They were also less likely to be Level I (highest) or Level II Trauma Centers. Rural hospitals had less access to physicians trained in emergency medicine, in pediatrics, or in pediatric emergency medicine. Rural hospitals had a lower overall score than urban hospitals on an inventory of 131 pediatric emergency supplies and equipment. However, the percent of all supplies that were available in rural hospitals was only 5.1 percentage points less than the percent available in urban hospitals.

Hospitals in our survey of rural hospital ED directors were similar to those in the EPSES rural panel. Findings include the following:

ED staff in every hospital had access to a medication chart for pediatric dosages and most had a special pediatric emergency cart. Few, however, had a special room in their ED for pediatric care. The availability of board-certified pediatricians and emergency medicine physicians was higher than in the EPSES rural sample. Most ED physicians or mid-level providers had Advanced Cardiac Life Support (ACLS) training and most hospitals reported that all of their ED physicians or mid-levels had Pediatric Advanced Life Support (PALS) training. Most rural hospitals reported that some or all ED nurses had PALS training. Many reported that some or all nurses had completed the Emergency Nursing Pediatric Course and most had some nurses with Trauma Nursing Core Curriculum training. Staff training was the most common need reported. Money to pay for training was the biggest barrier. Also cited was lack of training opportunities and staffing to cover when others were at training.

Rural Care and Mental Health Services

The Maine Rural Health Research Center has recenlty released a report on Rural Health Clinics (RHCs) that offer mental health services and those that might in the future.  Click here to read the paper that includes the research findings.  It includes barriers to implementing mental health services in RHCs, and suggestions for doing so.

Japanese Efforts Could Make Way Around Globe

Recent efforts in Japan to retain physicians in rural areas has other nations watching their technique to see if it will work for them. Click here to read an article about how Japan has overcome a physician shortage that was leaving their rural citizens without care.

Medicaid Expansion and Performance Research

PubHub has made the following reports available:

Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or Below 133% FPL
 
Estimates state and national cost increases from the 2010 health reform law's expansion of Medicaid to adults under age 65 with incomes up to 133 percent of the federal poverty line, in relation to enrollment increases under two outreach scenarios.

Enhancing the Capacity of Community Health Centers to Achieve High Performance
 
Based on a survey of community health centers, assesses access to care, care coordination, quality improvement efforts, health information technology adoption, and ability to serve as patient-centered medical homes. Suggests policy to strengthen clinics.

Patient Safety and Care

PubHub has made the following reports available:

Providing Underserved Patients With Medical Homes: Assessing the Readiness of Safety-Net Health Centers
 
Surveys safety-net health centers' potential to become patient-centered medical homes based on eight change concepts to improve care delivery, efficiency, and health outcomes. Outlines challenges, areas for improvement, and strategies for transformation.
 
The Patient Safety and Quality Improvement Act Regulations: Implications for Health Information Access and Exchange
 
Summarizes the 2008 law designed to prompt providers to report patient safety and healthcare quality information, the role of patient safety organizations, privacy and security issues, and implications for RWJF's Aligning Forces for Quality initiative.