Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

Context: Diabetes care is challenging in rural areas. Research has shown that the utilization of electronic patient registries improves care; however, improvements generally have been described in combination with other ongoing interventions. The level of basic registry utilization sufficient for positive change is unknown. Purpose: The goal of…

Context: Community input can lead to better-defined goals in an organization. With this in mind, the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences embarked on a series of 13 meetings with representatives of organizations serving rural communities, including 5 Native American reservations. Purpose:…

Context: Health disparities between rural and urban communities are well documented. There are many suggested causes and many proposed solutions but no one-size-fits-all answer. The most successful community interventions have been introduced by communities themselves. However, before communities invest in such interventions, each group must…

Context: Since the passage of the Balanced Budget Act of 1997, rural hospitals have struggled with the need to strategically adapt to an abundance of changing reimbursement and regulatory programs, as well as to respond to the needs of an increasingly frail elder population in need of postacute and long-term care (LTC). Purpose: This article has 2…

Context: Pregnant women in rural areas may give birth in either rural or urban hospitals. Differences in outcomes between rural and urban hospitals may influence patient decision making. Purpose: Trends in rural and urban obstetric deliveries and neonatal and maternal mortality in California were compared to inform policy development and patient…

Context and Purpose: With heightened attention to medical errors and patient safety, we surveyed Utah and Missouri hospitals to assess the "state of the art" in patient safety systems and identify changes over time. This study examines differences between urban and rural hospitals. Methods: Survey of all acute care hospitals in Utah and…

Purpose: To assess the extent of bypass for inpatient care among patients living in Critical Access Hospital (CAH) service areas, and to determine factors associated with bypass, the reasons for bypass, and what CAHs can do to retain patients locally. Methods: Six hundred and forty-seven subjects, aged 18 years and older, who had been admitted to…

Context: National data documenting the role that rural hospitals play in providing inpatient care to patients both younger than 65 and 65 years and older has previously been unavailable. Purpose: To present descriptive nationally representative data on the numbers and types of inpatients, and the care they received, in rural hospitals. Methods:…

Context: In studying physician shortage issues, few studies have utilized individual interviews, allowing rural physicians to voice their own stories. Purpose: To explore rural physicians' unique characteristics affecting their decisions and satisfactions with practice in a rural area. Methods: A qualitative interview study with 11 Nebraska family…

Context: An experimental Health Care Improvement Program (HCIP) was initiated by the Bureau of National Health Insurance in 1997 to improve the accessibility of health care in several rural, mountainous districts. Purpose: This longitudinal study evaluated service availability, utilization patterns, and effectiveness of services under the HCIP in…

Current efforts to address the severe and worsening shortage of rural physicians include attracting and preparing rural students for medical school, enhancing medical school curricula, and placing and retaining rural physicians. Recommendations include creating incentives for successful rural training programs, encouraging innovation in rural…