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OBJECTIVE To describe and explore relationships between social demographic factors and incidence or worsening of pressure ulcer scores among post-acute care (PAC) settings. DESIGN The authors present the incidence of new or worsening pressure ulcers stratified by self-reported patient race and sex. Investigators used logistic regression modeling to examine relative risk of developing new or worsened pressure ulcers by sociodemographic status and multiple regression modeling to estimate the relative contribution of facility-level factors on rates of new or worsening pressure ulcers. SETTING Three PAC settings: long-term care hospitals, inpatient rehabilitation facilities, and skilled nursing facilities. PARTICIPANTS Medicare Part A residents and patients with complete stays in PAC facilities during 2015. MAIN OUTCOME MEASURE The incidence of new or worsened pressure ulcers as calculated using the specifications of the National Quality Forum-endorsed pressure ulcer quality measure #0678. MAIN RESULTS The sample included 1,566,847 resident stays in 14,822 skilled nursing facilities, 478,292 patient stays in 1,132 inpatient rehabilitation facilities, and 121,834 patient stays in 397 long-term care hospitals. Significant differences in new or worsened pressure ulcer incidence rates by sociodemographic factors were found in all three settings. Black race, male sex, and advanced age were significant predictors of new or worsened ulcers, although controlling for health conditions reduced the racial disparity. The authors noted significant differences among facilities based on ownership type, urban/rural location, and sociodemographic makeup of facilities’ residents/patients. CONCLUSIONS There is evidence of disparities in the incidence of new or worsened pressure ulcers across PAC settings, suggesting publicly available quality data may be used to identify and ameliorate these problems.

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We evaluate the impact that the USDA’s low‐cost broadband loan programs have on the U.S. agricultural sector. The broadband loan programs increase access to high‐speed Internet in recipient communities, which can raise farm sales by increasing both farm output and prices received by producers. Further, high‐speed Internet may drive down costs by providing information on cheaper inputs and better management practices, leading to an overall improvement in farm profits. Using U.S. county‐level data on farm sales and expenditures in 2000 and 2007, we employ an inverse probability weighting technique to control for endogenous selection in an econometric model that also accounts for spatial dependence. We find that the two USDA broadband loan programs have had positive causal impacts on farm sales, expenditures, and profits in a subset of rural counties—those adjacent to metropolitan counties—but not in other types of counties.

We demonstrate how states that lifted restrictions on interstate bank expansions, thereby improving access to cheaper credit, experienced increased farm sales and net farm income. In our empirical analysis, we use nationwide county‐level data from 1970 through 2001 and a difference‐in‐differences econometric framework, exploiting only within‐state variation in banking deregulation, to distinguish the effect of an increase in bank competition from potential confounding factors. By including region‐by‐year fixed effects in our econometric equation, we compare changes in farm sales and expenditures in states that lift restrictions on interstate banking to changes in states that do not lift such restrictions within the same census region. Our estimates indicate that county‐level farm sales increase by about 3.4% and county‐level net farm income rises by $1.57 million (in 1982 dollars) after a state deregulates its banking sector by allowing interstate bank expansion. We also find evidence that farm expenditures, in particular expenditures on feed, fuel, machine and equipment rental, as well as interest payments, grew as a result of the banking deregulation. The positive impacts on farm sales, net income, and interest payments are larger in metropolitan counties than in rural counties, consistent with the notion that interstate bank entry following deregulation was concentrated in larger metropolitan markets, leading to a greater reduction in the cost of credit in those areas.