What Constitutes an Adequate Provider Network for Rural Health Populations?
The issue of narrow provider networks has become more serious as a result of the implementation of the ACA and the uncomfortable balance that needs to be made between reducing healthcare expenditures and providing local access to care. This study aims to develop norms/standards for provider network adequacy for rural populations (which may vary across different rural environments) that will be useful to consumers, providers, and policymakers in the decisions they face with respect to health plan choices, participation, and policies.
Rural Hospital Obstetric Workforce, Procedure Utilization, and Quality of Care
Approximately half a million women give birth in rural hospitals each year in the U.S. Workforce issues are an important constraint on obstetric care in rural hospitals, especially for small-volume obstetric units. However, limited research explores the relationship between obstetric care workforce and the procedure intensity and quality of childbirth care provided in rural hospitals in the U.S. This project will examine the relationships between key aspects of the obstetric workforce in rural hospitals and procedure intensity and quality of maternity care in those hospitals.
Identifying Adverse Drug Events and Improving Patient Safety in Rural Hospitals
Adverse drug events (ADEs) are the single largest category of hospital-acquired conditions (HACs), accounting for 34.2% of HACs in 2011. Medication safety in small rural hospitals is an important rural health policy. With this project, we will identify rates of ADEs and opportunities to improve patient safety in Critical Access Hospitals (CAHs) and non-CAH rural hospitals.
Quality Measures and Socioeconomic Risk Factors: The Rural Environmental Context
There has been significant discussion lately among researchers and policy-makers about whether or not to adjust provider quality measures for differences in patient characteristics. Lacking in this discussion, however, is an understanding of how adjustment should be done within a rural context and what impact it might have on patients and providers. The purposes of this project are, for three acute care conditions/diagnoses, to identify the key sociodemographic variables that may affect quality adjustment for rural populations/providers, identify data sources/strategies available for these variables, identify the quality measures (e.g. readmission rates) that should be adjusted for sociodemographic variables for rural populations/providers, and estimate the potential impact of those adjustments on quality measurement.