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Category Archives: Research

New Publication Available for Health Care Providers

A new publication is available from the North Carolina Rural Health Research & Policy Analysis Center. Download “Final Report: Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003 ” here.

This final report looks at whether the availability of post-acute skilled care has stabilized, and how and where it is being provided today, now that the reimbursement policy changes that began with the Balanced Budget Act of 1997 have been fully implemented.

Key findings include:

  • Options for post-acute skilled care are available for many rural residents but availability and choice are limited for some residents residing in the most rural areas.
  • The swing bed program represents a very small proportion of all post-acute skilled care in rural areas, but may be important for access for certain populations.
  • Access to hospital-based SNFs has declined in rural areas.
  • Swing bed participation and total swing bed days have grown.
  • The proportion of CAHs with swing beds has not changed and the contribution of swing beds to CAH average daily census has increased only modestly and only in the most rural areas.

Hospital Strategy to Reduce Readmission

PubHub has made the following report available:

Reducing Hospital Readmissions: Lessons From Top-Performing Hospitals
Synthesizes findings from four previous case studies of hospital strategies that help reduce patient readmission rates, including the use of health information technology, early care transition planning, and targeting high-risk patients for follow-up.

Care Coordination in Rural Settings

The following policy brief and report look at care coordination for rural patients, with a focus on transitions from inpatient care back to the rural community.  They suggest ways of measuring the quality of care coordination on discharge from the hospital.

Care Transitions: “Time to Come Home” (Policy Brief)

Care Transitions: “Time to Come Home” (Final Report)

Don't Keep 'Em Coming Back

PubHub has made the following report available:

St. John’s Regional Health Center: Following Heart Failure Patients After Discharge Avoids Readmissions

Outlines strategies that contribute to low readmission rates among patients with heart attacks, heart failure, and pneumonia, including physician incentives and post-discharge interventions for patients and community providers. Lists lessons learned.

Systems Benefiting Patient Safety

PubHub has made the following report available:

Keeping the Commitment: A Progress Report on Four Early Leaders in Patient Safety Improvement
Examines four healthcare systems’ expansion of patient safety interventions over five years through the development of practical training methods, effective tools for minimizing errors, an emphasis on goal setting and accountability, and other approaches.

Increasing Capacity for Patient Care

The Commonwealth Fund has made the following report available:

Most Americans get their health care in small physician practices. Yet, small practice settings are often unable to provide the same range of services or participate in quality improvement initiatives as large practices because they lack the staff, information technology, and office systems. One promising strategy is to share clinical support services and information systems with other practices. New findings from the 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians suggest smaller practices that share resources are more likely than those without shared resources to have advanced electronic medical records and health information technology, routinely track and manage patient information, have after-hours care arrangements, and engage in quality monitoring and benchmarking. This issue brief highlights strategies that can increase resources among small- and medium-sized practices and efforts supported by states, the private sector, and the Affordable Care Act that encourage the expansion of shared-resource models. Find more on this study by clicking here.

Primary Care Delivery

Pubhub has made the following report available:

Designing Safety-Net Clinics for Innovative Care Delivery Models
Outlines key design features of and recommendations for primary care delivery models in safety-net clinics: co-location and outreach of services, patient-centered care, space for team collaboration, and use of new technology. Illustrates examples.