The Rising Rate of Rural Hospital Closures

Kaufman, Brystana G.; Thomas, Sharita R; Randolph, Randy; Perry, Julie R.; Thompson, Kevin W.; Holmes, George M.; Pink, George H.

doi:10.1111/jrh.12128

Cited by 236 publications

(215 citation statements)

References 16 publications

Supporting

Mentioning

207

Contrasting

Order By: Relevance

“…closures of health centers during economic depression) or disorganized health services that may attenuate the success of new primary and secondary prevention efforts to reduce AMI. 58,59 Interestingly, AMI hospitalizations and mortality declined at a similar pace across low- and high-income communities, suggesting that a single factor or intervention was not responsible for the decline. If so, one might have expected admission rates in low-income counties to drop more rapidly since they started with higher rates.…”

Section: Discussionmentioning

confidence: 99%

Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013

et al. 2016

View full text Add to dashboard Cite

Importance Over the last decade, acute myocardial infarction (AMI) incidence and mortality have decreased substantially. Yet it is unknown whether these improvements were consistent across communities of different economic status and geographic regions, for which efforts to improve cardiovascular disease prevention and management may have had variable impact. Objective To determine whether trends in county-level risk-standardized AMI hospitalization and mortality rates varied by county-based median income level. Design Observational study from 1999 to 2013. Setting National study of U.S. counties. Participants County-level risk-standardized (age, sex, race) hospitalization and 1-year mortality rates for AMI from 1999 to 2013 were measured for Medicare beneficiaries ≥65 years. Exposures Counties were stratified by median income percentile using 1999 U.S. Census Bureau data, adjusted for inflation: low (<25th), average (25–75th) or high (>75th) income groups. Main Outcome and Measure We examined the effect of income on the slope of AMI hospitalizations and mortality. We measured differences in rate of change in AMI hospitalizations and mortality by county income and by the 4 U.S. geographic regions. We also tested for a ‘lag’ effect among low-income counties. Results In the 15-year period, AMI risk-standardized hospitalization and mortality rates decreased significantly for all three county income groups. Average hospitalization rates were significantly higher among low-income counties compared with high-income counties, with rates for low-income counties in 2013 lower than for high-income counties in 1999 (853 versus 1,123 per 100,000 person years, respectively). 1-year mortality rates after hospitalization for AMI were similar across county income groups, decreasing from 1999 (31.5%, 31.4%, and 31.1%, for high, average and low income counties, respectively) to 2013 (26.2%, 26.1%, and 25.4%). The rate of decline in AMI hospitalizations was similar for all county income groups; however, low-income counties lagged behind high-income counties by 4.3 (95% CI 3.1 to 5.9) years. There were no differences in trends across geographic regions. Conclusion and Relevance AMI hospitalization and mortality rates declined among counties of all income levels, though hospitalization rates among low-income counties lag behind. These findings lend support for a more targeted community-based approached to AMI prevention.

show abstract

Section: Discussionmentioning

confidence: 99%

Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013

et al. 2016

View full text Add to dashboard Cite

show abstract

“…23 Healthcare access and coordination of care may be further strained by rural hospital closures, as 47 rural hospitals closed between 2010 and 2014, largely due to lack of financial sustainability and decreasing patient populations. 43 To mitigate these challenges, future programming and policy should promote creative solutions to improve availability of providers. These may include facilitating partnerships between rural providers and larger healthcare systems to create ACOs, in an effort to improve coordination of care and access to specialty care providers.…”

Section: Discussionmentioning

confidence: 99%

Health care eligibility and availability and health care reform: Are we addressing rural women’s barriers to accessing care?

Zimmermann¹,

Carnahan²,

Paulsey³

et al. 2016

Journal of Health Care for the Poor and Underserved

View full text Add to dashboard Cite

Background Rural populations in the US face numerous barriers to healthcare access. The Patient Protection and Affordable Care Act (PPACA) was developed in part to reduce healthcare access barriers. We report rural women’s access barriers and the PPACA elements that address these barriers as well as potential gaps. Methods For this qualitative study, we analyzed two datasets using a common framework. We used content analysis to understand rural, focus group participants’ access barriers prior to PPACA implementation. Subsequently, we analyzed the PPACA text. Results Participants described healthcare access barriers in two domains: availability and eligibility. The PPACA proposes solutions within each domain, including healthcare workforce training, Medicaid expansion, and employer-based health care provisions. However, in rural settings, access barriers likely persist. Discussion While elements of the PPACA address some healthcare access barriers, additional research and policy development are needed to comprehensively and equitably address persistent access barriers for rural women.

show abstract

“…Neoliberal government‐driven ideologies have seen a reduction in acute and hospital services in rural environments . Consequently, primary health‐care services are generally first point of contact for older people when they are unwell.…”

Section: Introductionmentioning

confidence: 99%

Accessing rural health services: Results from a qualitative narrative gerontological study

et al. 2019

View full text Add to dashboard Cite

Objective Explore how older adults’ talk about accessing rural community health services. Methods A qualitative narrative gerontological approach explored issues related to accessing health services in their community. Semi‐structured digitally recorded individual interviews were undertaken with 32 community‐dwelling older people aged between 75 and 93 years. A narrative data analytic process was undertaken. The COnsolidated criteria for REporting Qualitative research guidelines were followed to ensure rigour in this study. Results Three collective narratives resulted from the data analytic process: (a) “accessing local health services”; (b) “accessing specialist services”; and (c) “accessing emergency services.” Conclusions Narrators identified a number of issues related to accessing rural health services. These included long waiting times, lack of continuity in care provision by doctors and difficulties accessing specialist and emergency services. Nurses were frequently cited as a reliable point of contact for these older people. Expansion of nursing roles would enhance the provision of rural health‐care services.

show abstract

The Rising Rate of Rural Hospital Closures

Cited by 236 publications

References 16 publications

Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013

Geographic Variation in Trends and Disparities in Acute Myocardial Infarction Hospitalization and Mortality by Income Levels, 1999-2013

Health care eligibility and availability and health care reform: Are we addressing rural women’s barriers to accessing care?

Accessing rural health services: Results from a qualitative narrative gerontological study

Contact Info

Product

Resources

About