Financial resilience of rural hospitals: Prepandemic vulnerabilities and Provider Relief Funds' role during COVID-19.

Purpose: Rural hospitals struggling with prepandemic financial instability faced heightened challenges during COVID-19. While Provider Relief Funds (PRFs) offered essential support, their impact varied, highlighting the need to examine how prepandemic financial health influenced rural hospitals' financial performance during the pandemic. This study evaluates PRF's role across three hospital categories: financially strained (low operating margin), financially vulnerable (midrange operating margin), and financially strong (high operating margin).

Exploring telehealth adoption and financial outcomes for rural hospitals during the COVID-19 public health emergency.

Purpose: To examine factors associated with rural hospital telehealth adoption during the COVID-19 public health emergency (PHE), and evaluate its relationship with rural hospital financial performance before and during the PHE.

Methods: This panel study used retrospective data (2017-2021) from the American Hospital Association Annual Survey, the Centers for Medicare & Medicaid Services Healthcare Cost Report Information Systems, and the Area Health Resource File. Rural hospitals were categorized as persistent adopters, persistent nonadopters, or switchers based on telehealth adoption status.

Financial Performance of Hospital Telehealth Adopters, Nonadopters, and Switchers: A Rural-Urban Comparison.

Goals: The adoption of telehealth in healthcare delivery has transformed patient treatment options. Urban and rural hospitals are increasingly using telehealth to reach more patients, improve patient engagement, and increase healthcare quality. Hospitals experience the operational benefits of adopting telehealth through improving clinical workflow, increasing efficiency, and improving patient satisfaction.

Community social vulnerability and the 340B Drug Pricing Program: Evaluating predictors of 340B participation among critical access hospital.

Purpose: The federal 340B Drug Pricing Program allows eligible hospitals, including critical access hospitals (CAHs), to obtain outpatient drugs at a discounted rate. CAHs likely benefit from 340B participation because they are often under-resourced and serve at-risk patient populations. The objective of this study was to understand predictors of 340B program participation among CAHs, and how participation varies with community-level social vulnerability.

Hospital Finances During the First Two Years of the COVID-19 Pandemic: Evidence From Washington State Hospitals.

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor and supplies, and a disparate impact on already disadvantaged populations. Many of these intersecting challenges put pressure on hospitals' finances.

Rural-urban disparities in the incidence and treatment intensity of periodontal disease among patients with diabetes.

Background: Diabetes threatens population health, especially in rural areas. Diabetes and periodontal diseases have a bidirectional relationship. A persistence of rural-urban disparities in diabetes may indicate a rural-urban difference in periodontal disease among patients with diabetes; however, the evidence is lacking.

The association of closed-collaborative SICU modeling on emergency general surgery patient outcomes.

Objective: Surgical intensive care unit (SICU) optimization is a critical factor impacting patient outcomes and resource utilization. SICUs operate using an open or closed model, where the surgeon or intensivist, respectively, manages critically-ill patients. In 2017, we adopted a closed-collaborative model.

Analysis of Injuries in Competitive Equestrian Events.

Objective: Current equestrian sport-related acute injury research is sparse. The goal of this study is to explore equestrian injury types stratified by population and equestrian discipline.

Design: Injury reports from the US Equestrian Federation (USEF) were compiled from 2015 through 2019, and the prevalence of different injury types within the main equestrian disciplines was calculated.

The Impact of Palliative Medicine Consultation on Readmission Rates and Hospital Costs in Surgical Patients Requiring Prolonged Mechanical Ventilation.

Background: The use of palliative care for critically ill hospitalized patients has expanded. However, it is still underutilized in surgical specialties. Postsurgical patients requiring prolonged mechanical ventilation have increased mortality and costs of care; outcomes from adding palliative care services to this population have been poorly investigated.

Variations in Cost and Readmissions of Patients in the Bundled Payment for Care Improvement Bundle for Hip and Femur Fractures.

Introduction: The Bundled Payment for Care Improvement (BPCI) for hip and femur fractures is an effort to increase care quality and coordination at a lower cost. The bundle includes all patients undergoing an operative fixation of a hip or femur fracture (diagnosis-related group codes 480-482). This study aims to investigate variance in the hospital cost and readmission rates for patients within the bundle.

Relationship between political partisanship and COVID-19 deaths: future implications for public health.

Background: COVID-19 has impacted more than 200 countries. However in the USA, the response to the COVID-19 pandemic has been politically polarized. The objective of this study is to investigate the association between political partisanship and COVID-19 deaths rates in the USA.

Deaths From COVID-19 in Rural, Micropolitan, and Metropolitan Areas: A County-Level Comparison.

Purpose: The United States has experienced a surge of COVID-19 cases and deaths. Regardless of the overall increase in the prevalence and mortality, there are disagreements about the consequences of exposure and contracting COVID-19, specifically in rural areas. Rural areas have inherent characteristics that increase their vulnerability to contracting COVID-19.

Financial Performance of Hospitals in the Appalachian Region Under the Hospital Readmissions Reduction Program and Hospital Value-Based Purchasing Program.

Purpose: The Hospital Readmission and Reduction Program (HRRP) and Hospital Value-Based Purchasing Program (HVBP) propose to improve quality of patient care by either rewarding or penalizing hospitals through inpatient reimbursement. This study analyzes the effect of both programs on profitability of hospitals located in the Appalachian Region (AR) compared to hospitals in Appalachian states and the rest of the United States.

Methods: This study used a retrospective research design with a longitudinal unbalanced panel dataset from 2008 to 2015.

Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre.

Objectives: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.

Design: Retrospective cohort study.

The Effect of the Magnet Recognition Signal on Hospital Financial Performance.

The objective of this study was to investigate the effect of the Magnet Recognition (MR) signal on hospital financial performance. MR is a quality designation granted by the American Nurses Credentialing Center (ANCC). Growing evidence shows that MR hospitals are associated with various interrelated positive outcomes that have been theorized to affect hospital financial performance.

Morning report decreases length of stay in trauma patients.

Background: Modern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.

Methods: The University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team.

Four Needles in a Haystack: A Systematic Review Assessing Quality of Health Care in Specialty Practice by Practice Type.

Specialists, who represent 60% of physicians in the United States, are consolidating into large group practices, but the degree to which group practice type facilitates the delivery of high quality of care in specialty settings is unknown. We conducted a systematic literature review to identify the impact of group practice type on the quality of care among specialty providers. The search resulted in 913 articles, of which only 4 met inclusion criteria.

Influence of a province-wide trauma system on motor vehicle collision process of trauma care and mortality: a 10-year follow-up evaluation.

Background: Mature trauma systems have evolved to respond to major injury-related morbidity and mortality. Studies of mature trauma systems have demonstrated improved survival, especially among seriously injured patients. From 1995 to 1998, a province-wide trauma system was implemented in the province of Nova Scotia.

Major traumatic brain injury: time to tertiary care and the impact of a clinical guideline.

Background: To achieve timely access to neurosurgical care for adult brain-injured patients, a Head Injury Guideline was implemented to standardize the emergency department evaluation and management of these patients. The goals of this study were to document times to neurosurgical care for patients with major traumatic brain injury presenting to a Provincial emergency room and to evaluate the impact of the Guideline on timely access to definitive care.

Methods: Data collected prospectively and stored in the Nova Scotia Trauma Registry and the Emergency Health Services Communications and Dispatch Centre database were analyzed for patients with head abbreviated injury scale score (AIS)≥3.

The epidemiology of surgically treated acute subdural and epidural hematomas in patients with head injuries: a population-based study.

Background: The purpose of this paper is to review the population-based epidemiology of surgically treated post-traumatic epidural hematomas (EDHs) and/or subdural hematomas (SDHs) among patients who presented to the single neurosurgical centre in Nova Scotia.

Methods: We included all patients aged 16 years or older who presented to the tertiary care hospital with acute post-traumatic EDHs and/or SDHs between May 23, 1996, and May 22, 2005, and who were surgically treated. We generated an initial cohort from the provincial trauma registry and reviewed a total of 152 charts for possible inclusion; 70 (46%) patients met the study criteria.